Clinical experience with therapeutic arteriovenous fistulae

Brescia-Cimino arterio-venous fistulae have been used as blood access for intermittent hemodialysis in 67 patients between 1972-74. The mean age of 32 men and 35 women was 48. Thirty-five patients were dialyzed through an external arterio-venous shunt for as long as 7 years before they received a fistula. Of 92 operations, 63 (68.5%) were successful. Ten patients (14.9%) never received a functioning fistula. The mean function time of 63 fistulae was 8.3 months. Twenty-two functioning fistulae eventually failed. In 11 cases no precipitating factor could be found. In six patients, septicemia coincided with infection at the fistula puncture site. Cardiac decompensation because of augmented venous return to the heart was not observed. Advantages and disadvantages with the Brescia-Cimino fistula are discussed and compared with the Quinton-Scribner shunt.