ABSTRACT
The best and most durable vascular access is autogenous direct AV fistula created in the
forearm, of which there are a number of variations including radial-cephalic, ulnar-basilic,
radial-basilic and ulnar-cephalic (1,2). Autogenous fistulae constructed at the elbow level are
much less durable, and prosthetic grafts are the most prone to thrombosis and infection. The
construction, maintenance and salvage of autogenous AV fistulae in the forearm should be a
priority in the management of renal failure patients, especially in those with presumed long
life expectancy.
