Arteriovenous Communication: Internal Fistulas

Abstract

The introduction by Brescia et al.¹ of the radial artery-to-cephalic vein fistula for hemodialysis was the most important innovation in vascular access. An internal arteriovenous fistula avoids the disadvantages of an external appliance, such as frequent septic and clotting problems. Over the years, the Brescia-Cimino fistula has become the best access for maintenance hemodialysis, because of its low incidence of complications and high long-term patency rate. The 1- and 3-year cumulative patency rates are 85–90% and 60–85%, respectively.