THE CREATION OF ARTIFICIAL SUBCUTANEOUS ARTERIOVENOUS FISTULAS IN PATIENTS WITH MALIGNANT HEMATOLOGICAL DISEASE

Creation of an artificial subcutaneous arteriovenous fistula was attempted in five patients with malignant hæmatological disorders (two with Hodgkin's disease, two with acute lymphatic leukæmia, and one with acute myeloid leukæmia). The average time from the start of treatment to attempted creation of the fistulæ was four years. Neither direct arteriovenous anastomosis nor an interposition mandril graft was successful in any patient. Failure was attributed to impaired venous run‐off secondary to previous episodes of thrombophlebitis induced by the intravenous administration of cytotoxic drugs. The use of an arteriovenous fistula early in the course of the disease might minimize these later problems.