Abstract

AbstractWith prolonged survival resulting from chemotherapy of acute leukemia, vascular access becomes a major problem for the patient and the physician. This is because of the need for multiple venipunctures, prolonged intravenous chemotherapy, and the local irritant effect of the drugs currently in use. Surgically created arteriovenous fistulas between the radial artery and the cephalic vein produce, in the forecrm, engorged veins with a rapid blood flow and thus obviate this problem. The fistula should be created shortly after the diagnosis is made and before or synchronous with the start of intravenous chemotherapy. Fistulas attempted later on sclerotic veins will almost always fail. The procedure has been performed with little morbidity, no mortality, and few complications in 26 patients, and has become an integral part of our treatment of this disease. This relatively simple and harmless surgical procedure has greatly improved patient comfort during intravenous chemotherapy for acute leukemia.