Journal of the American College of Surgeons
The most recent articles from:
J. Am. Coll. Surg.
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Obesity in the hemodialysis population is roughly twice that of the general population. An arteriovenous fistula (AVF) remains the recommended vascular access; however, obesity results in fewer autogenous accesses, more complexity, and higher AVF failure rates. We reviewed our vascular access experience in obese individuals in whom the depth of an AVF prevented reliable cannulation. ⋯ A variety of surgical options were found to be successful in establishing a functional autogenous vascular access for individuals in whom cannulation sites were simply too deep. Cumulative patency rates for all patients were 93% at 1 year and 91% after 2 years.