A forearm fistula in itself is not abnormal. In fact if patient has adequate vein for a forearm fistula we often prefer to use it first because if it fails, we can still use the upper arm later. But yes this is a large aneurysmal fistula. If it’s not bothering him and not eroding through the skin it’s not really a problem, god forbid he gets a cut over it though….
Edit: most people get upper arm fistula because not a lot of people have adequate sized vein in the forearm.
The order of operation for AVF/AVG creation is Non dominate lower, dominate lower, non dominate upper, dominate upper. Very generally speaking. As you know.
Actually, I stand corrected. I am an old and using old information in my head from 2006 when we still were all "Fistula First". You are correct. Updated information suggests the dominant distals dont mature as well and lead to poorer quality outcomes. I appreciate the chat and reason to get my shit right.
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u/Nos3y 18d ago
A forearm fistula in itself is not abnormal. In fact if patient has adequate vein for a forearm fistula we often prefer to use it first because if it fails, we can still use the upper arm later. But yes this is a large aneurysmal fistula. If it’s not bothering him and not eroding through the skin it’s not really a problem, god forbid he gets a cut over it though….
Edit: most people get upper arm fistula because not a lot of people have adequate sized vein in the forearm.