Spergel Lawrence M, Ravani Pietro, Asif Arif, Roy-Chaudhury Prabir, Besarab Anatole
Dialysis Management Medical Group, San Francisco, California 94109, USA.
J Nephrol. 2007 May-Jun;20(3):288-98.
The Fistula First Breakthrough Initiative (FFBI) shows that development of multidisciplinary teams with designated vascular access coordinators is the key to success in increasing the appropriate use of the arteriovenous fistula as access for hemodialysis. Since nephrologists should communicate expectations to surgeons regarding fistula placement and their ability to use the access repeatedly, current surgical techniques based on KDOQI guidelines and best practices are summarized in this review. These may serve also as bases for the education of the surgical community. Autogenous fistula options include primary native fistula creation in the forearm, arm and lower extremity which can be direct or based on transposed or translocated venous vessels. Optimizing autogenous options for hemodialysis requires vessel mapping and a surgeon's willingness to invest additional time and effort.
动静脉内瘘优先突破倡议（FFBI）表明，组建由指定血管通路协调员组成的多学科团队是成功增加动静脉内瘘作为血液透析通路合理使用率的关键。由于肾病学家应就内瘘置入及其反复使用通路的能力向外科医生传达期望，本综述总结了基于KDOQI指南和最佳实践的当前外科技术。这些也可作为对外科界进行教育的基础。自体动静脉内瘘的选择包括在前臂、上臂和下肢直接创建原发性自体动静脉内瘘，或基于转位或移位静脉血管创建。优化血液透析的自体动静脉内瘘选择需要进行血管造影，并且外科医生愿意投入额外的时间和精力。
