Current techniques for permanent vascular access surgery — experience with 930 procedures

1991 
Successful construction and maintenance of satisfactory long-term vascular access is the single-most challenging surgical procedure carried out for patients with end-stage renal disease requiring chronic hemodialysis. The Brescia-Cimino fistula between radial artery and cephalic vein at the wrist was described in 1966 and has remained the primary vascular procedure of choice for hemodialysis in most patients (1). When it is not possible to construct this fistula or after a failure of such a fistula, secondary vascular access procedures may have to be carried out which include Brachio cephalic fistula at the elbow, or the use of arterio venous grafts (2–5). The Kuwait Transplant Team has been actively involved in the construction and modification of vascular accesses for the past 10 years.
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