Page 71 - Virtual Vascular Vol 13

Matured Arterio-venous Fistula

This patient has history of end-stage renal failure. He had a radiocephalic AVF

created for haemodialysis at wrist (also called “Brescia-Cimino fistula” after
invention by Drs. James Cimino and Michael J. Brescia in 1966)

After surgical anastomosis of the cephalic vein to the radial artery, the high flow
arterial blood travels to the low resistance cephalic vein. Maturation of the AVF
gradually occurs in few weeks causing increase in flow and dilatation of the

vein. This allows adequate flow of blood and easy needling for the connection
to a haemodialysis machine

This patient later received a renal transplantation and no longer needs HD.

Surgical ligation of the AVF is performed to avoid symptoms arising from the
AVF 71