Quinton-Scribner arteriovenous shunts for hemodialysis. A review of 6.5 years' experience

Quinton-Scribner shunts have been used as a reliable access to the blood-stream in 56 patients treated with intermittent hemodialysis in the years 1965-71. The mean age of 29 men and 27 women was 39 years. Two hundred and thirty-two cannulae showed a mean survival time of 11.2 months for 103 arterial cannulae and 9.0 months for 129 venous cannulae. 700 shunt clotting episodes occurred during 1157 patient months, i.e. 0.6 clotting episode/month. In 350 episodes where saline flushing could not remove the clot, the effect of treatment with streptokinase was considered evident in 79.7%. Shunt cannula infection was a common complication while aseptic cutaneous necrosis and bleeding from the cannulated vessel were seen less frequently. Both severe and less harmful bleeding episodes were seen as a complication of dicumarol therapy. The number of complications to streptokinase treatments was low. The advantages and disadvantages of the Quinton-Scribner shunt for hemodialysis are discussed.