title: Superficialization of the wrist native arteriovenous fistula for effective hemodialysis vascular access construction.
abstract: BACKGROUND
  It is commonly known that the best type of vascular access for chronic hemodialysis, defined as the one with the lowest number of complications and longest use, is the primary (Brescia-Cimino) radiocephalic fistula. One reason for the impossibility of its creation is that the vein vessel on the forearm is located too deeply, which is primarily caused by the patients' obesity.
  
  
  METHODS
  In 24 obese patients the superficialization procedure of the venous part of fistula under the skin was performed.
  
  
  RESULTS
  In 23 patients of this group, an easy and uncomplicated fistula puncturing was achieved. One patient had the complication of fistula clotting.
  
  
  CONCLUSIONS
  Subcutaneous transposition of the arterialized median antebrachial vein is a simple and effective method of an adequate distal native fistula creation in patients with deeply located forearm veins.
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Traugutta 57/59, 50-417 Wrocław, Poland. klinef@poczta.onet.pl
authors.forename: Wacław
authors.initials: W
authors.lastname: Weyde
authors.forename: Magdalena
authors.initials: M
authors.lastname: Krajewska
authors.forename: Waldemar
authors.initials: W
authors.lastname: Letachowicz
authors.forename: Marian
authors.initials: M
authors.lastname: Klinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D001808:Blood Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D006435:Renal Dialysis; D018615:Ultrasonography, Doppler, Color; D014953:Wrist / Q000098:blood supply*