Abstract
Endogenous arteriovenous fistula (AVF), first described in 1966, remains the optimal vascular access for chronic dialysis. An internal AVF avoids the disadvantages of an external appliance, such as frequent septic and clotting problems. In spite of surgical innovations, such as autogenous vein interpositional grafts, bovine heterografts, expanded polytetrafluoroethylene (ePTFE) grafts and permanent indwelling silastic central venous catheters, the Brescia–Cimino fistula has remained the best access for maintenance haemodialysis because of its low incidence of complications and high long-term patency rate. The 1- and 3-year cumulative patency rates are 85–90% and 60–85% respectively.
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