Dialysis access surgery: Brescia-Cimino (radiocephalic) fistula – Vascular surgery - vascular surgery
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Dissecting the cephalic vein
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.
Note the switch to atraumatic forceps at the start of the vessel dissection.
Dissecting the radial artery
Preparing the end-of-vein-to-side-of-artery anastomosis, checking shunt vein patency
Preparing the radial artery, fashioning the end-to-side anastomosis with the cephalic vein
Wound closure, Doppler monitoring