Evaluation of venocutaneous fistula as vascular access for hemodialysis: Examination of 46 limbs of 40 patients

Introduction: We have previously evaluated the usefulness of venocutaneous fistula (VCF), also called “dermatorrhea.” VCF is a technique of blood removal/return by advancing a dialysis cannula to the femoral vein for each hemodialysis session using a fistula created between the great saphenous vein and skin. Methods: In this study, we evaluated 46 limbs of 40 patients for whom VCF was created at our hospital between May 2017 and April 2022. In all the patients, it was difficult to construct an arteriovenous fistula or arteriovenous graft because of the general/vascular conditions. The usefulness of this method was evaluated based on the results of dialysis treatment after fistula creation and the use of fistula. Results: Fundamental evaluation confirmed the progression of vascular wall thickening over time. During clinical review, no serious complications were found in any patient during or after fistula creation surgery. The infection rate was 0.30/1000 days of fistula maintenance. Secondary patency rates by the Kaplan–Meier method were 87.0% at 1 year and 42.6% at 3 years. Conclusion: This method has demonstrated a good patency rate, low infection rate, and seems to be a potentially useful alternative in patients in whom it is difficult to establish vascular access.