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Abstract
Permanent methods that allow vascular access for months to years include subcutaneous anastomosis of an extremity artery to a nearby vein (arterio-venous fistula) , subcutaneous interposition of a tube graft between an extremity art, and vein (arterio-venous graft) , and implantation of a cuffed double-lumen silicone elastomer catheter (e.g. Permeath device) into an internal jugular vein.”.
The most commonly used method for creating a permanent vascular access in patients with chronic renal failure is the prim, arterio-venous (AV) fistula and it is considered the optimal choice in patients who have end-stage renal disease and require repeated hemodialysis. These fistulas commonly done using the radial artery .d the cephalic vein in the distal part of the patient’s non dominant forearm (fig.2). It can last as long as 20 years with appropriate care. In the absence of suitable vessels , alternative fistulas may be constructed between the ulnar artery and the basilic vein at the distal forearm , the brachial artery and the cephalic ’As at the distal upper arm , or the brachial artery .d the basilic vein at the distal upper arm.