Abstract
Various methods of shunt operation are available for gaining blood access in hemodialysis, among, which internal shunt is in most favorite use nowadays. We make it a practice to perform a side-to-side anastomosis of the radial artery and radial cutaneous vein somewhat proximal to the wrist on the opposite side of the whip arm as the procedure of first choice. Unfortunatery, however, there are cases in which the vein is too small to ensure sufficient blood flow to accomplish hemodislysis or in which, after the surgical creation of a shunt, the formation of a varix, or even occlusion, results from frequent puncture. In such an instance we have used a vascular prosthesis. The purpose of this paper is to descride our experience with newly developed 4-6 tapered Gore tex graft in the creation of A-V fistula. The procedure consists of anastmosing a prosthesis of 4mm diameter with the artery and another of 6mm diameter with the vein. The prostheses provided a satisfactory run off with an inproved patency rate and thus proved to be effective in the creation of A-V fistula under unfavorable conditions.
