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  • Title: [The Nakayama technique of shunt creation for chronic hemodialysis. Experience, complications and possibilities of their removal].
    Author: Hempel D, Knothe C.
    Journal: Chirurg; 1977 Nov; 48(11):713-8. PubMed ID: 923365.
    Abstract:
    The Brescia-Cimino fistula is carried out as an end-to-end anastomosis for mechanical flow reasons. The Nakayama anastomosis in the upper plexus anesthesia is carried out as a fast and simple apparatus method. Between 1973 and June 1977, 114 Nakayama anastomoses were performed in 80 patients. Till June 1977, 61 were still usable. Time and cause of occlusion were analyzed. Early occlusion (within 30 days) was mainly caused by faulty operation. Late occlusion (within 4 months) was mainly caused by thrombosis at the tantalum ring and improper usage. Shunt occlusion was remedied by a new connection on the same or on the other arm, by vein replantation, or by construction of a vein loop. The arteria femoralis was placed in subcutaneous position when blood vessel conditions were unfavorable. Tests with Spark's prosthesis and autologous vein transplantation produced no usable vessels.
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