Conversion of external arteriovenous hemodialysis shunt to internal fistula

The preservation of arteriovenous (AV) access site is important to long-term survival of patient's requiring maintenance hemodialysis life-support therapy. Patients with chronic renal failure and uremia who are not suited for immediate application of a subcutaneous AV fistula or arteriovenous graft and who require an initial Teflon-Silastic AV shunt to initiate urgent hemodialysis need not lose these vessels when the AV shunt is removed. After venous maturation, these patients should have a subcutaneous AV fistula created from the uninfected, unclotted shunt before infection or clotting would cause loss of these vessels.