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October 21, 1974

Arteriovenous Fistula For Self-Treatment of Hemophilia

Author Affiliations

From the Blood Bank and Surgical Service of Beth Israel Medical Center and the Mt. Sinai School of Medicine of the City University of New York, New York.

JAMA. 1974;230(3):437-438. doi:10.1001/jama.1974.03240030055029

THE need for a safe, long-lasting, repetitive, and convenient vascular channel for hemodialysis has been satisfied by the development of the internal arteriovenous fistula by Brescia et al.1 This technique is easier and less hazardous to patients with bleeding diathesis than that reported by Ries et al.2 Hemodialysis at home is a possibility, since venipuncture using the fistula can now easily be accomplished by the patient or a family member. Such a fistula has proved to be long lasting and free of complications.3,4 It can resolve the problem of the patient with difficult veins who needs intravenous therapy in the hospital or at home.5

Difficult Venipuncture  The application of the principle of the arteriovenous fistula to the management of hemophilia was suggested when difficulties in venipuncture made hospital care essential for our patient with each minor episode of bleeding. Following the creation of the shunt, the