Experience with different types of fistulas and shunts for hemodialysis.

Three alternative methods to obtain access to the circulatory system for hemodialysis has been used. The Cimono-Brescia fistula is the method of choice and is almost always successful if the vessels are intact. The femoral Quinton-Scribner shunt has proved unreliable and dangerous. The subdermal vein graft is a useful and acceptable alternative if the vessels of the upper limbs have been destroyed.