Page 58 - Virtual Vascular Vol 5
P. 58

Radiocephalic and Brachiocephalic AVF Creation







     Preoperative duplex ultrasound mapping of both upper limbs





































     *For Asians, venous luminal diameter of >2mm is considered adequate as outflow for
     AVF creation


                 - Non-dominant arm preferrable


                 - Distal to proximal, to preserve proximal sites






                At wrist                No       At elbow                 No                            No
                Good radial artery               Good brachial artery            Adequate Basilic vein         AV Graft
                Adequate cephalic vein           Adequate cephalic vein


                  Yes                               Yes                              Yes


   Radiocephalic (snuffbox or wrist) AVF     Brachiocephalic (elbow) AVF        Basilic vein transposition





            - No further revision possible, same algorithm used on dominant arm

            - No further revision possible, lower limb long saphenous vein loop AVF, followed

            by AV graft at upper limbs, followed by AV graft at lower limbs

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