Superficialization of the wrist native arteriovenous fistula for effective hemodialysis vascular access construction

Abstract

Background. It is commonly known that the best type of vascular access for chronic hemodialysis, defined as the one with the lowest number of complications and longest use, is the primary (Brescia-Cimino) radiocephalic fistula. One reason for the impossibility of its creation is that the vein vessel on the forearm is located too deeply, which is primarily caused by the patients' obesity. Methods. In 24 obese patients the superficialization procedure of the venous part of fistula under the skin was performed. Results. In 23 patients of this group, an easy and uncomplicated fistula puncturing was achieved. One patient had the complication of fistula clotting. Conclusion. Subcutaneous transposition of the arterialized median antebrachial vein is a simple and effective method of an adequate distal native fistula creation in patients with deeply located forearm veins.