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October 9, 1967

Arteriovenous Shunts for Prolonged Intermittent Hemodialysis: Technique, Survival, and Complications in 57 Patients

Author Affiliations

From the University of Colorado Medical Center, Denver, and the Department of Surgery, Division of Urology, State University of New York, Downstate Medical Center, Brooklyn.

JAMA. 1967;202(2):99-103. doi:10.1001/jama.1967.03130150067010

To facilitate repeated intermittent hemodialysis, 57 patients at the University of Colorado Medical Center and the Denver Veterans Administration Hospital had arteriovenous shunts placed into their arms. The radial artery and cephalic vein were cannulated 3 cm proximal to the wrist on the nondominant arm. Fifty-four of the 57 patients had both vessels cannulated through a single incision, with an average length of 5 cm. The ligating suture on the vessel was tied around that portion of the siliconized rubber (Silastic) tube containing the vessel tip. Disengagement at this junction or postoperative bleeding requiring transfusion or surgical intervention never occurred. Twelve of the 17 patients who experienced complications (clotting, 12 instances; infection, 7; spasm, 3; disengagement, 2; and erosion, 2) required revision of their shunts. No complication was ever observed in the remaining 40 patients during their entire stay on the dialysis program.