長期血液透析における前腕部皮下動静脈瘻設置について

Abstract

Arteriovenous fistula was surgically created subcutanecusly in the forearm of six patients with terminal uremia due to chronic renal insufficiency in order to arterialize the vein. Repeated hemodialysis was then atteinpted using venipuncture. In two cases, blood flow for the extracorporeal circulation was 270ml per minute when 15-gauge venipuncture needles were used, and 120 to 200 ml per minute (150 ml in average) when 19-9auge needles used. The blood flow obtained in this method was, therefore, satisfactory for hemodialysis, In another two cases, the blood flow obtained was only 80ml per minute in average which was insufficient for hemodialysis. In one case, a fistula became obstructed several days after surgically created. In the last case, the patient had died before it was used. From the above experience, discussions were made on the clinical significance and indication of subcutaneous arteriovenous fistula creation in the forearm for chronic hemodialysis.