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Updated: Aug 11, 2025

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
Published on: April 1, 2022
Proximalization through one incision of a wrist arteriovenous fistula and distal revascularization with interval
Andre Rafizadeh1, Thomas Lee1, Kevin James1
1Department of Surgery, Morristown Medical Center, Morristown, NJ.
Abstract:
In the setting of ischemic steal syndrome with tissue loss, patients with radiocephalic fistulas have limited options to preserve their conduit and treat their ischemic symptoms. To address this, we have proposed the technique of proximalization through one incision of a wrist arteriovenous fistula (POWR) with distal revascularization with interval ligation (DRIL) procedure. In the present retrospective, single-center, case series, we evaluated the outcomes of three patients with radiocephalic fistulas who had undergone POWR DRIL from 2017 to 2021. Their ischemic symptoms were monitored for regression. All three patients showed signs of regressing ischemia. The POWR DRIL represents an efficient procedure to address tissue loss and preserve the autogenous conduit.
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