Abstract
IntroductionThe creation of the first arteriovenous fistula (AVF) as far distally in the upper limb as possible is ideal. We developed a new operative technique for creating a radial artery-second dorsal metacarpal vein AVF in the first interdigital space. This technique involves the creation of the AVF using the most peripheral site and autologous vein in the upper limb. Case presentationWe herein describe the steps of this technique and its successful performance in a 71-year-old man with end-stage renal disease. DiscussionThis technique has several advantages including preserving many future vascular access options and providing a long segment of arterialized vein for cannulation. ConclusionWe consider this technique to be a worthwhile option and recommend the use in patients with the proper vessels for the creation of the AVF.
Highlights
The creation of the first arteriovenous fistula (AVF) as far distally in the upper limb as possible is ideal
We previously reported an operative technique for creating a transposed radial artery-second dorsal metacarpal vein AVF (TRSDAVF) in the anatomical snuffbox (AS) using the most distal autologous vein in the upper limb [6]
We reported an operative technique for creating a radial artery-first dorsal metacarpal vein AVF (RFDAVF) in the first interdigital space (FIS) of the dorsal hand using the most distal site in the upper limb [7]
Summary
The creation of the first arteriovenous fistula (AVF) as far distally in the upper limb as possible is ideal. We developed a new operative technique for creating a radial artery-second dorsal metacarpal vein AVF in the first interdigital space. This technique involves the creation of the AVF using the most peripheral site and autologous vein in the upper limb. DISCUSSION: This technique has several advantages including preserving many future vascular access options and providing a long segment of arterialized vein for cannulation.
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