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Updated: Apr 11, 2026
07:30
Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
Published on: April 1, 2022
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Snuffbox Versus Wrist Radiocephalic Arteriovenous Fistulas: 10 Years Experience
Mohamed S M Elshikhawoda1, Aidas Raudonaitis2, Tarig Barakat2
1Vascular Surgery, Glan Clwyd Hospital, Rhyl, GBR.
Cureus
|May 3, 2024
Summary
The anatomical snuffbox arteriovenous fistula (SBAVF) is a viable alternative to the wrist radiocephalic arteriovenous fistula (RCAVF) for hemodialysis vascular access. This study found SBAVF to be a suitable first-choice option for patients requiring vascular access.
Area of Science:
- Vascular Surgery
- Nephrology
- Dialysis Access
Background:
- The wrist radiocephalic arteriovenous fistula (RCAVF) is the standard initial procedure for hemodialysis vascular access (HVA).
- The anatomical snuffbox arteriovenous fistula (SBAVF) is underutilized despite its distal location.
- This study compares the outcomes of SBAVF and RCAVF.
Purpose of the Study:
- To analyze and compare the maturity, patency, and failure rates of SBAVF and RCAVF.
- To evaluate the feasibility of SBAVF as a primary HVA procedure.
Main Methods:
- A descriptive, retrospective study design.
- Comparison of outcomes between SBAVF and RCAVF in patients with chronic kidney disease.
- Data collected from Betsi Cadwaladr University Health Board between 2013 and 2023.
Main Results:
- 179 patients were included; 76% underwent RCAVF and 24% underwent SBAVF.
- Overall fistula success rate was 58.7% (105/179), with 67 failures.
- Fistula failure showed a significant relationship with complications (p=0.000).
- Fistula site, hypertension, diabetes, cardiac disease, smoking, PVD, or central vein stenosis did not significantly affect fistula failure.
Conclusions:
- The anatomical snuffbox arteriovenous fistula (SBAVF) is a suitable and feasible first choice for hemodialysis vascular access.
- SBAVF offers a viable alternative to traditional RCAVF procedures.
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