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Autogenous radial-cephalic direct wrist arteriovenous fistula (RCF), the gold standard for chronic dialysis, suffers from an elevated early failure rate (up to 20-50% with a pooled rate of 15.3%). Guidelines indicate that a small radial artery internal diameter (&lt;1.6-2 mm) is strongly predictive of this early failure. Microsurgery and preventive haemostasis have been reported to give excellent results in a paediatric population (children &lt;10 kg bw) and have shown a much lower early failure rate of 5-10%. Given these excellent results, we have used microsurgery along with preventive haemostasis in adult patients. We herein describe the results of RCF created in patients with a radial artery internal diameter &lt;1.6 mm.

nephrology, dialysis, transplantation/nephrology dialysis transplantation

Microsurgery and preventive haemostasis for autogenous radial-cephalic direct wrist access in adult patients with radial artery internal diameter below 1.6 mm