title: Small skin incision and fistula elevation for hemodialysis using the femoral vein.
abstract: BACKGROUND
  Wound morbidity commonly accompanies transposition of the femoral vein when used for hemodialysis access, mainly because of the length of the skin incision. A short incision may reduce wound complications but may compromise the arteriovenous (AV) function because of the shorter length of femoral vein available for puncture. This report presents our experience with a modification of the original technique, in which a smaller skin incision and fistula elevation were used.
  
  
  METHODS
  The clinical course of 25 AV fistulas in the thigh using the femoral vein was retrospectively analyzed. The original technique to create femoral AV access was used in 12 patients and the modified technique in 13. The procedures were performed between 2005 and 2007, and patients were monitored until January 31, 2011.
  
  
  RESULTS
  Three fistulas failed in each group. Five patients in the original group had wound complications. No wound complications occurred in the modified group. The fistula was first used at an average of 10.45 weeks and 6.14 weeks, respectively. Patency was similar in both groups.
  
  
  CONCLUSIONS
  It is possible to obtain a functional AV fistula in the thigh using the femoral vessels and limiting the extent of the incision. Long-term patency is reasonable, despite the use of a short femoral segment for puncture.
authors.affiliation: Department of Vascular Surgery, Hospital Central, Colonia Universitaria, San Luis Potosí, Mexico. alcocerfrancisco@hotmail.com
authors.forename: Francisco
authors.initials: F
authors.lastname: Alcocer
authors.forename: Saul
authors.initials: S
authors.lastname: Perez
authors.forename: Camilo
authors.initials: C
authors.lastname: Martinez
mesh_terms: D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D016009:Chi-Square Distribution; D062109:Dermatologic Surgical Procedures; D005260:Female; D005268:Femoral Vein / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D015993:Life Tables; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D006435:Renal Dialysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013848:Thigh / Q000098:blood supply*; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency