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Related Concept Videos

Veins of Upper Limbs01:17

Veins of Upper Limbs

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The human circulatory system, a marvel of biological engineering, is a complex network of vessels that transport blood throughout the body. Among these, the veins responsible for carrying blood from the upper limbs are divided into two categories: deep and superficial.
The deep venous system is primarily composed of the ulnar and radial veins. The ulnar vein, which drains the fingers through the superficial palmar venous arches, and the radial vein, which serves the palms via the deep palmar...
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Arteries of the Upper Limbs01:12

Arteries of the Upper Limbs

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The subclavian artery transitions into the axillary artery as it exits the chest and enters the axillary region. This artery is critical for supplying blood to the shoulder area, including the head of the humerus, through the humeral circumflex arteries. As the vessel continues into the upper arm or brachium, it becomes the brachial artery. This artery plays a key role in vascularizing the brachial region and bifurcates at the elbow into several branches. These branches include the deep...
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Sites for measuring blood pressure01:21

Sites for measuring blood pressure

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Blood pressure measurement is a fundamental clinical procedure, providing crucial data for assessing cardiovascular health. Among the various sites for this measurement, the brachial and popliteal arteries are predominantly utilized due to their accessibility and the reliability of their readings. This lesson delves into the anatomical significance, methodology, and considerations of measuring blood pressure at these locations.
The Brachial Artery: Primary Site for Blood Pressure Measurement
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The Arch of Aorta01:10

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The coronary arteries, originating from the ascending aorta, bifurcate from two sinuses located within the ascending aorta. Positioned just above the aortic semilunar valve, these sinuses house essential aortic baroreceptors and chemoreceptors, crucial for maintaining cardiac function. The left coronary artery and the right coronary artery branch off from the left posterior and anterior aortic sinuses, respectively.
Encircling the heart, the coronary arteries form a ring-like structure before...
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Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

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Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
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Related Experiment Video

Updated: Apr 16, 2026

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
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Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique

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Brachiocephalic and basilic fistula.

Selcuk Baktiroglu1, Fatih Yanar, Alper Ozturk

  • 1Istanbul University, Istanbul Medical Faculty, General Surgery Clinic, Istanbul - Turkey.

The Journal of Vascular Access
|March 10, 2015
PubMed
Summary

Forearm arteriovenous fistulas (AVFs) should be prioritized for hemodialysis access due to lower complication rates and vessel preservation. Brachiocephalic AVFs are a preferred secondary option when forearm fistulas fail.

Area of Science:

  • Vascular Surgery
  • Nephrology
  • Dialysis Access

Background:

  • Hemodialysis requires reliable vascular access, with arteriovenous fistulas (AVFs) being the preferred method.
  • Increasing life expectancy in hemodialysis patients necessitates consideration of secondary and tertiary access procedures.
  • Current guidelines often recommend Brescia-Cimino radiocephalic AVFs as the primary choice, but recent evidence suggests alternatives.

Purpose of the Study:

  • To evaluate the optimal sequence of vascular access procedures for long-term hemodialysis.
  • To compare the efficacy and complication rates of different AVF types.
  • To inform clinical decision-making regarding primary versus secondary vascular access creation.

Main Methods:

  • Review of existing literature and clinical guidelines on AVF creation.

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  • Analysis of patient outcomes, including maturation, patency, and complication rates.
  • Comparison of forearm AVFs (radiocephalic) versus upper arm AVFs (brachiocephalic and brachiobasilic).

    • Main Results:

    • Forearm AVFs should be attempted first to preserve vessels and minimize complications.
    • Brachiocephalic AVFs are a suitable secondary option when forearm fistulas fail, offering easier cannulation and less invasive surgery.
    • Elbow fistulas are generally not recommended as primary access, especially in vulnerable patient populations.

    Conclusions:

    • Prioritizing forearm AVFs optimizes long-term vascular access by reducing complications and preserving vessel options.
    • Brachiocephalic AVF is the preferred choice over brachiobasilic AVF when both veins are suitable, due to surgical simplicity and safety.
    • Clinical practice should emphasize forearm AVF creation as the initial approach for hemodialysis patients.