title: The snuffbox fistula should be preferred over the wrist arteriovenous fistula.
abstract: OBJECTIVE
  The snuffbox arteriovenous fistula (SBAVF) is the most distal native vascular access. Although published data show a favorable outcome, the SBAVF is not strongly recommended by the guidelines. The present study compared the patency of SBAVFs and wrist AVFs (WAVFs).
  
  
  METHODS
  All 416 AVFs created by the same nephrologist from March 2006 to October 2014 were reviewed. From 416 procedures, 47 SBAVFs and 77 WAVFs with vessels suitable for a SBAVF were selected.
  
  
  RESULTS
  Although vessel diameters used for construction of the SBAVFs were smaller than those used for WAVFs, the outcome of vascular access was similar. At 18 months, primary patency was 72% for SBAVF and 65% for WAVF (P = .48), and secondary patency was 93% for SBAVF and 94% for WAVF (P = .89).
  
  
  CONCLUSIONS
  In our experience, a SBAVF performs as well as a WAVF up to 18 months after creation. We suggest favoring SBAVF, especially in young patients without comorbidities, as the primary vascular access.
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland. Electronic address: letach@poczta.onet.pl.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Letachowicz
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Gołębiowski
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Kusztal
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Letachowicz
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland; Faculty of Dentistry, Wrocław Medical University, Wrocław, Poland.
authors.forename: Wacław
authors.initials: W
authors.lastname: Weyde
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland.
authors.forename: Marian
authors.initials: M
authors.lastname: Klinger
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000379:methods*; D015897:Comorbidity; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D017534:Radial Artery / Q000503:physiopathology / Q000601:surgery*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014680:Veins / Q000503:physiopathology / Q000601:surgery*; D014953:Wrist / Q000098:blood supply*; D055815:Young Adult