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Updated: Feb 2, 2026
10:10
A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail
Published on: February 3, 2016
13.9K
Distal-to-Snuffbox Arteriovenous Fistula.
Dale Maharaj1, Michael James Ramdass2, Rayaad Baksh2
1Caribbean Vascular and Vein Clinic, Port of Spain, Trinidad and Tobago.
Summary
Creating a distal-to-snuffbox arteriovenous fistula (AVF) in the hand is a viable option for end-stage renal disease patients. This technique offers acceptable primary patency rates, providing surgeons with more vascular access options.
Area of Science:
- Vascular Surgery
- Nephrology
- Dialysis Access
Background:
- The standard practice for arteriovenous fistula (AVF) creation emphasizes distal upper limb placement.
- This study investigates an alternative distal AVF technique in the hand, termed the distal-to-snuffbox AVF (HAVF).
Observation:
- A 10-year prospective study included 31 patients with end-stage renal disease undergoing HAVF creation.
- Patient selection criteria included a minimum 3mm distal cephalic vein diameter and a normal Allen's test.
Findings:
- The HAVF demonstrated primary patency rates of 90% at 12 months, decreasing to 82% at 60 months.
- Overall failure rate was 19%, with most failures occurring beyond the initial 2 weeks post-procedure.
Implications:
- The distal-to-snuffbox AVF is a successful alternative for dialysis access in carefully selected patients.
- This technique expands surgical options for creating functional arteriovenous fistulas, potentially improving patient outcomes.
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