Problems with bovine heterografts for hemodialysis. Recognition, correction, and prevention

1. Careful examination of the peripheral blood vessels is essential in choosing the site for an arteriovenous heterograft. 2. Ischemia of the hand or fingers was avoided by placing upper extremity grafts in the forearm. 3. In the lower extremity, if peripheral pulses are normal, a straight thigh graft is preferred. 4. The recipient vien in the antecubital fossa should be no less than 4 mm in diameter; in the lower extremity the venous anastomosis should be made to the common femoral vein. 5. "Graft hypertension" is a sign of inadequate venous runoff and should be corrected before false aneurysms develop or occlusion of the graft occurs. 6. Most thrombosed grafts can be reopened and should be explored promptly through an incision near the venous end.