Page 59 - Virtual Vascular Vol 5

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

- Right-handed

- Adequate radial artery and cephalic vein at wrist
- No further revision possible, same algorithm used on dominant arm - For Left Radiocephalic AV fistula creation

- 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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