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Updated: May 29, 2026
07:30
Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
Published on: April 1, 2022
Alternative autogenous arteriovenous hemodialysis access options
William C Jennings1, Kevin E Taubman
1Department of Surgery, University of Oklahoma College of Medicine, Tulsa, OK 74135, USA. William-Jennings@ouhsc.edu
Seminars in Vascular Surgery
|September 6, 2011
Summary
Autogenous arteriovenous fistula (AVF) is the preferred hemodialysis access. This review explores alternative surgical AVF options for complex patients, aiming to avoid prosthetic grafts and central venous catheters.
Area of Science:
- Vascular Surgery
- Nephrology
- Dialysis Access
Background:
- Autogenous arteriovenous fistula (AVF) is the recommended vascular access for hemodialysis.
- Established guidelines exist, but complex patient anatomy can hinder AVF creation.
Purpose of the Study:
- To review alternative surgical procedures for establishing successful AVFs in challenging patients.
- To emphasize avoiding prosthetic arteriovenous accesses and central venous catheters.
Main Methods:
- Review of established surgical options and clinical practice recommendations.
- Discussion of alternative AVF configurations for patients with limited venous outflow or arterial insufficiency.
- Integration of clinical history, physical examination, and advanced imaging techniques.
Main Results:
- Alternative AVF procedures can enable successful access creation in complex cases.
- Avoiding prosthetic and catheter-based access is feasible for most patients.
- Comprehensive pre- and postoperative imaging is crucial for patient selection and success.
Conclusions:
- Successful AVF creation is achievable in most hemodialysis patients, even those with complex anatomy.
- Alternative AVF techniques offer viable solutions when standard methods fail.
- Prioritizing autogenous AVF over prosthetic or catheter access improves patient outcomes.
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