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KMID : 0378019800230030064
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New Medical Journal
1980 Volume.23 No. 3 p.64 ~ p.68
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Simultaneous Arteriovenous Shunt and Fistula for Immediate and Longterm Hemodialysis
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Abstract
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Dialyses are essential for the irreversible end stage renal failure patients to maintain their life because dialysis removes endogenous toxic products & fluid, reinstitutes acid-base balance & electrolyte homeostasis.
Of the dialysis procedures, hemodialysis has been proved to be most effective and arteriovenous connection of good flow is prerequisite for longterm hemodialysis.
The classical external arteriovenous shunt, as originally described by Quinton et a1.,5> i& exellent for the immediate use but the shunt life is limited and it is not preferred for chronic longterm hemodialysis.
Since Brescia et al.,l) introduced an arteriovenous fistula for chronic use, now arteriovenous fistulas as well as fistulas created with graft are accepted worldwidely.
But arteriovenous fistula needs at least two weeks´ interval to be puntuied and is not. suitable for immediate use.
Frequently, some patients with acute renal failure need urgent hemodialysis and cannot wait long for the fistula to mature.
Recently other means of vascular access have been reported for the purpose of immediate as well as chronic hemodialysis.
Simonian et al.,´) Buselmeier et al.,z) and Sigley et al.,6) have proposed conversion. operation of Scribner external shunt to arteriovenous fistula for chronic hemodialysis.
Sterling$) reported another vascular access using Gore-Tex graft with attachment of a. silastic tube to the graft to construct external shunt.
Since March 1969, when the first successful clinical renal transplantation was performed in Korea at Catholic Medical Center, we have constructed 212 arteriovenous connections (shunts or fistulas) on 182 patients for hemodialysis.
Recently we have devised new method of vascular access suitable for `´immediate as. well as chronic hemodialysis.
This article present the details of this procedures and the results in our six patients.
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KEYWORD
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