Microsurgery for “wrist” arteriovenous fistula creation in children: a retrospective cohort study



Creating functional arteriovenous fistulae (AVF) at the wrist is challenging in paediatric patients because of the small calibre of the blood vessels.


We report our experience with AVF surgery in children younger than 15 years of age using microsurgical techniques. Twenty-five patients underwent AVF surgery between 2003 and 2015 (20 for haemodialysis, 4 for plasmapheresis and 1 for parenteral nutrition). Median (range) age was 9 (2-15) years and median weight was 24 (8-61) kg.


The one-month occlusion rate was 8%. The primary and secondary patency rates at 1, 2, 3 years were: 60%, 49%, 42%, and 82%, 72%, 54%, respectively. The median (range) maturation time was 4.53 (0.5-11.2) months. We found no statistically significant effect of patient age, body weight, type of AVF and indication for AVF creation on the primary and secondary patency rates.


Microsurgical AVF creation at the wrist can be performed with satisfactory results and should be the preferred technique in the paediatric population.

Post author correction


Article Subject: Dialysis



Afram Akturk, Roel Bakx, Michiel J.S. Oosterveld, Jim C.H. Wilde, Mirza M. Idu

Article History


Financial support: No grants or funding have been received for this study.
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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  • Department of Vascular Surgery, Emma Children Hospital, Academic Medical Center, Amsterdam - The Netherlands
  • Department of Paediatric Surgery, Emma Children Hospital, Academic Medical Center, Amsterdam - The Netherlands
  • Paediatric Nephrology, Emma Children Hospital, Academic Medical Center, Amsterdam - The Netherlands

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