Large vessel appliqué arteriovenous shunt for hemodialysis: A new concept

Abstract

<h2>Summary</h2> A high-flow arteriovenous shunt has been developed which is attached to the common femoral artery and vein. This large vessel "appliqué" shunt resulted from the vexations of repeated cannulations in aging patients receiving dialysis using the standard peripheral arm or leg arteriovenous shunt. Thirty-nine patients have been operated on for a total of forty shunts and these patients have been followed up for from four to eighteen and a half months, with satisfactory results to date. Complications other than infection have been negligible and readily handled without rehospitalization and reoperation. Forty per cent of the patients are receiving anticoagulation therapy for repetitive minor shunt thromboses and heavy fibrin formation on the artificial kidney. Infection remains a serious problem and has caused the death of two patients. Further follow-up studies will ultimately make it possible to ascertain whether or not this concept, with continuing changes in the prosthesis, will be adequate for all patients. As it stands currently, it is a readily satisfactory back-up and support shunt when all other available shunt sites have been used. Acceptance by the patient of this femoral shunt, with its position, high-flow characteristics and ease of handling, is high.