To the Editor.—The creation of an arteriovenous fistula represents a major advance in allowing use of the artificial kidney for renal dialysis. Continued improvement in the technique of cannula insertion for the creation of an arteriovenous fistula has allowed a wider use of chronic hemodialysis. Recently, advantages of the surgically created arteriovenous fistula have become apparent.
With the increasing use of the Doppler ultrasonic flowmeter as an adjuvant in the diagnosis and management of vascular problems, a wide spectrum of indications for its use has been described, including corrective surgery of congenital arteriovenous fistulae, cirsoid malformation, congenital angiomas, and in the correction of coronary arteriovenous fistulae.1,2
Useful information for the creation and evaluation of an arteriovenous shunt with the dialysis cannulae may be provided by the Doppler ultrasonic flowmeter. Since the patency of the shunt is essential to long-term hemodialysis, it is obvious that the best possible vascular