title: The middle-arm fistula: A new native arteriovenous vascular access for hemodialysis patients.
abstract: Dialysis access procedures and complications are important causes of morbidity and hospitalization for chronic hemodialysis patients. The number of complicated subjects on dialysis is increasing, and creating a successful native arteriovenous fistula for these patients is a challenge. The classic Brescia-Cimino fistula may not be the best first choice for a native vascular access. We describe the surgical technique of middle-arm fistula (MAF) for hemodialysis. A total of 112 surgical procedures were performed on 106 patients with primary unassisted 24- and 48-month patency rates of 93% and 83%, respectively, and a very low incidence of complications. Our approach was found to be a useful method in patients with comorbid factors.
authors.affiliation: Nephrology and Dialysis Unit, AO Ospedale Civile di Vimercate, Desio Hospital, Desio, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bonforte
authors.forename: Simona
authors.initials: S
authors.lastname: Zerbi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Surian
mesh_terms: D000368:Aged; D001132:Arm / Q000098:blood supply*; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D006435:Renal Dialysis