Dialysis access surgery: Brescia-Cimino (radiocephalic) fistula – Vascular surgery

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  1. Local anesthesia

    Video
    Local anesthesia
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    Inject about 5 ml of prilocaine (Xylonest®) 1% into the distal left forearm between the cephalic vein and radial artery.

  2. Dissecting the cephalic vein

    Video
    Dissecting the cephalic vein
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    Fashion an approximately 3 cm long longitudinal incision between radial artery and cephalic vein. Dissect and isolate the vein in the subcutaneous plane. Initially preserve the continuity of the shunt vein to protect its endothelium.

    Tip:

    Note the switch to atraumatic forceps at the start of the vessel dissection.

Dissecting the radial artery

Make a radial incision into the connective tissue of the sheath and expose the radial artery. Encir

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