Arteriovenous Shunts for Hemodialysis

William A. Kisken, MD; Richard J. Jones, MD; Louis C. Bernhardt, MD; Gholam H. Malek, MD; Arvin B. Weinstein, MD
Arch Surg. 1968;97(4):634-636. doi:10.1001/archsurg.1968.01340040130025.
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SCRIBNER, in 1960, reported the treatment of chronic uremia by intermittent hemodialysis through an external arteriovenous shunt.1,2 The silicone rubber (Silastic) arteriovenous shunt has been utilized at the University of Wisconsin Hospitals in patients in need of dialysis for the past 18 months, with a low complication and failure rate. Although our dialysis program is chiefly concerned with supporting patients prior to renal transplantation, an external arteriovenous shunt is also placed in all patients with acute renal failure in need of dialysis. Several techniques have evolved which have helped to maintain a low failure rate both initially and chronically. This report stresses the details which seem to make the difference between successful and complicated cannulations.

Techniques  The nondominant arm is usually used for cannulation. The patient is examined carefully before surgery to ascertain the presence of a patent radial artery and an unthrombosed vein near the radial artery. The


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