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January 29, 1968

Lower-Extremity Shunts for Hemodialysis

Author Affiliations

From the departments of surgery (Dr. Faris) and medicine (Drs. Alfrey, Schorr and Ogden), University of Colorado Medical Center and Veterans Administration Hospital, Denver.

JAMA. 1968;203(5):344-346. doi:10.1001/jama.1968.03140050028006

Thirty-two shunt procedures for hemodialysis were performed in the lower extremities. There were 26 Teflon and Teflon-Silastic (fluorocarbon-siliconized rubber) arteriovenous cannulas and six arteriovenous anastomoses. Three fistulas were used, with Teflon-Silastic venovenous cannulas in the great saphenous vein. The duration of function was short and the incidence of thrombosis high with the peripheral arteriovenous and venovenous plastic shunts. Both anterior tibial arterial cannulas in the midleg gave prolonged excellent flow. Venipuncture of the arterialized great saphenous vein proved to be difficult. The lower extremities provide additional sites for shunts; however, the arms have been superior and are used if satisfactory vessels are available. More proximal leg shunts may prove to be an exception and become important for self-dialysis.