Bovine graft arteriovenous fistulas for maintenance hemodialysis

Modified bovine carotid artery grafts have been used for maintenance hemodialysis in 44 patients during an 18 month period. The technique of constructing an arteriovenous fistula in the leg and in the forearm is described. The common femoral artery and saphenous vein in the leg and the radial artery and basilic vein in the forearm are the preferred vessels. The complication rate has been low, consisting primarily of thrombosis and false aneurysms at the dialysis needle puncture site. Oversized grafts should be avoided because of resultant turbulent flow and the tendency of thrombosis. Bleeding after withdrawal of the hemodialysis needle must be properly controlled to minimize complications. Eighty-two percent have various problems and 18 per cent have failed. Bovine graft arteriovenous fistulas provide excellent vascular access in patients undergoing chronic hemodialysis.