Laskar M, Benevent D, Charmes J P, Rince M, Leroux-Robert C, Christides C
J Mal Vasc. 1984;9(3):201-5.
Out of an experience of 244 vascular access in 150 patients the authors try do find the best chronology of the angioaccess procedures. 68% of the patients see their need in vascular access definitely resolved by the first classical forearm internal arterio-venous fistula and everything must be done in the dialysis population to avoid the failure of the fistula. This would lead to internal shunt procedures using graft materials of which we know the limited potency, leading to periodic operations. Emergency situations are approached by use of the femoral vein catheterization for hemodialysis. Only the impossibility of femoral or jugular catheterization would lead to the use of the external A.V. Shunt which would be placed on the leg to preserve the vessels of the arms. For some patients the repeated failure of the successive A.V. fistula and shunts have drived us towards either peritoneal dialysis or "hemasite" vascular access system.
在对150例患者进行244次血管通路建立的经验基础上，作者试图找出血管通路手术的最佳时间顺序。68%的患者通过首次经典的前臂动静脉内瘘，其血管通路需求得到了明确解决，并且在透析人群中必须采取一切措施避免内瘘失败。这将导致使用我们已知效能有限的移植材料进行内分流手术，从而需要定期进行手术。紧急情况通过使用股静脉置管进行血液透析来处理。只有在无法进行股静脉或颈静脉置管时，才会使用外置动静脉分流，且会将其置于腿部以保护手臂的血管。对于一些患者，连续的动静脉内瘘和分流反复失败，促使我们选择腹膜透析或“血液位点”血管通路系统。
