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The Middle-arm Fistula: A New Native Arteriovenous Vascular Access for Hemodialysis Patients

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Annals of Vascular Surgery

Abstract

Dialysis access procedures and complications are important causes of morbidity and hospitalization for chronic hemodialysis patients. The number of complicated subjects on dialysis is increasing, and creating a successful native arteriovenous fistula for these patients is a challenge. The classic Brescia-Cimino fistula may not be the best first choice for a native vascular access. We describe the surgical technique of middle-arm fistula (MAF) for hemodialysis. A total of 112 surgical procedures were performed on 106 patients with primary unassisted 24- and 48-month patency rates of 93% and 83%, respectively, and a very low incidence of complications. Our approach was found to be a useful method in patients with comorbid factors.

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Acknowledgments

The authors are members of the Italian Vascular Access Study Group and thank its directive members for valuable advice.

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Authors and Affiliations

  1. Nephrology and Dialysis Unit, AO ‘Ospedale Civile’ di Vimercate–Desio Hospital, Desio, Italy

    Giuseppe Bonforte MD, Simona Zerbi MD & Maurizio Surian MD

Authors
  1. Giuseppe Bonforte MD
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  2. Simona Zerbi MD
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  3. Maurizio Surian MD
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Corresponding author

Correspondence to Simona Zerbi MD.

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Bonforte, G., Zerbi, S. & Surian, M. The Middle-arm Fistula: A New Native Arteriovenous Vascular Access for Hemodialysis Patients. Ann Vasc Surg 18, 448–452 (2004). https://doi.org/10.1007/s10016-004-0054-1

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  • DOI: https://doi.org/10.1007/s10016-004-0054-1

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