An upper arm A-V fistula for hemodialysis patients with distal access failures.

The technique of creating an upper arm side-to-side A-V fistula in patients with forearm vascular access failures has been described. The procedure has been used extensively in patients in Japan with a high degree of success. The limited U.S. experience has confirmed that the procedure results in trouble-free, reliable vascular access. It is proposed as an alternative approach for patients with forearm access failures.