Vascular access may be defined as any technique that allows removal from and delivery of fluids into the circulatory system at a rate of 200 ml/min or more for lengthy interval.
In 1966 Brescia et al reported their experience with the radiocephalic arteriovenous fistula constructed at the wrist. This procedure ensured the cephalic vein would be kept distended even through blood was continuosly and rapidly withdrawn from the vein. The blood was then passed through the dialyser and returned to the proximal segment of same arterialized vein or to another vein. The advantage of Brescia-Cimino fistula was the absence of implanted prosthetic materials. The disadventage was its common need for time to mature before its unsuitability for emergency use.
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