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Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
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The middle-arm fistula: A new native arteriovenous vascular access for hemodialysis patients

Giuseppe Bonforte1, Simona Zerbi, Maurizio Surian

  • 1Nephrology and Dialysis Unit, AO Ospedale Civile di Vimercate, Desio Hospital, Desio, Italy.

Annals of Vascular Surgery
|June 4, 2004
PubMed

Dialysis access procedures and complications are important causes of morbidity and hospitalization for chronic hemodialysis patients. The number of complicated subjects on dialysis is increasing, and creating a successful native arteriovenous fistula for these patients is a challenge. The classic Brescia-Cimino fistula may not be the best first choice for a native vascular access. We describe the surgical technique of middle-arm fistula (MAF) for hemodialysis. A total of 112 surgical procedures were performed on 106 patients with primary unassisted 24- and 48-month patency rates of 93% and 83%, respectively, and a very low incidence of complications. Our approach was found to be a useful method in patients with comorbid factors.

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