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Related Experiment Video

Updated: Mar 24, 2026

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
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Interventions for failed wrist fistulae: Is it worthwhile?

Surendra Shenoy1, Michaeline Wood1, Sarah Matson1

  • 1Washington University in Saint Louis, School of Medicine, Barnes Jewish Hospital, Saint Louis, Missouri - USA.

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|March 9, 2016
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Summary

Forearm fistulas are ideal for dialysis but often fail due to thrombosis. This review explores surgical and interventional techniques to salvage failing fistulas, improving patient outcomes.

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Area of Science:

  • Nephrology
  • Vascular Surgery

Background:

  • Arteriovenous fistulas (AVFs) are the preferred vascular access for hemodialysis due to their longevity and low complication rates.
  • However, high rates of thrombosis and maturation failure limit AVF benefits for many patients.
  • Salvage interventions offer a potential solution for failing AVFs.

Purpose of the Study:

  • To review current surgical and interventional techniques for salvaging failing forearm fistulas.
  • To classify modes of AVF access failure and salvage modalities.
  • To propose an algorithm for identifying suitable candidates and guiding treatment selection.

Main Methods:

  • Review of existing literature on surgical and interventional salvage techniques for forearm fistulas.
  • Classification of AVF failure presentations.
  • Development of a decision-making algorithm for salvage interventions.

Main Results:

  • Surgical and interventional techniques can successfully salvage failing forearm fistulas.
  • Different AVF failure modes require tailored salvage approaches.
  • An algorithm can aid in selecting appropriate interventions for AVF salvage.

Conclusions:

  • Salvaging failing forearm fistulas can restore long-term dialysis access.
  • Timely intervention and appropriate modality selection are crucial for successful AVF salvage.
  • Restoring fistula function allows patients to benefit from AVF advantages.