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Related Concept Videos

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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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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Related Experiment Video

Updated: Dec 29, 2025

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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Technical note: An alternative method for AV access superficialization.

Danielle Fontenot1, Karl A Illig2

  • 1Division of Vascular Surgery, Department of Surgery, University of South Florida, Tampa, FL, USA.

The Journal of Vascular Access
|January 30, 2020
PubMed
Summary
This summary is machine-generated.

A novel technique effectively superficializes deep arteriovenous fistulae for dialysis access, improving cannulation success. This minimally invasive approach elevates the fistula to the dermis without re-anastomosis, enhancing usability for hemodialysis patients.

Keywords:
AV access complicationsAV access revisionAV fistulaAV fistula superficializationtechniques and procedures

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Area of Science:

  • Vascular Surgery
  • Nephrology
  • Dialysis Access

Background:

  • Arteriovenous fistulae (AVF) are crucial for hemodialysis access.
  • Superficial AVF are necessary for reliable cannulation.
  • Deep AVF pose challenges for effective dialysis access.

Purpose of the Study:

  • To describe a new technique for superficializing deep AVF.
  • To improve cannulation reliability in patients with deep AVF.

Main Methods:

  • Ultrasound marking of the fistula path.
  • Creation of multiple small transverse incisions.
  • Mobilization and dermal elevation of the fistula vein.
  • Closure of superficial fascia and adipose tissue to secure the elevated fistula.

Main Results:

  • 100% technical success in 20 patients.
  • High 3-month patency rate of 94.4%.
  • Functional patency for hemodialysis achieved in 87.5% of patients.
  • Minimally invasive approach preserves virgin skin and normal contour.

Conclusions:

  • The described technique successfully elevates deep AVF to the dermal level.
  • This method avoids fistula division, re-anastomosis, or re-tunneling.
  • The technique facilitates easier and more reliable cannulation for hemodialysis.