ABSTRACT
Long-term administration of intravenous drugs for chemotherapy causes irreversible lesions of the superficial veins, particularly in children. Since 1972 we have performed arteriovenous fistulas in order to obtain an enlargement of the superficial veins of the arm, with an increased arterial blood flow and an hypertrophy of the walls. Side-to-side anastomosis between the radial artery and cephalic vein gives the best enlargement of superficial forearm veins, and vascular access becomes easier. If the cephalic vein has thick walls, with poor blood flow, this vessel cannot be used because of a high risk of thrombosis. A total of 57 fistulas have been performed by conventional techniques, with a 36% rate of early thrombosis. Arteriovenous fistulas are useful for venous preservation during chemotherapy. In an emergency, the catheter gives an easy vascular access, but the fistula is more comfortable for long-term chemotherapy.
