Vol. 9, Issue 1, Part D (2025)

Introduction: RCAVF is a prototype HD access with low infection rate and less distal ischemia. It can be placed anywhere on the forearm and hand, including the anterior part of the forearm, the wrist, or the ASB on the back of the hand. The native radiocephalic arteriovenous fistula (RCAVF) is the vascular access of choice for HD in patients with end-stage renal failure.
Objective: To analyze the outcome of creating an arteriovenous fistula between the radial artery and cephalic vein on the first attempt.
Methods: The descriptive cross-sectional cadaveric study was done at Department of Surgery, MAG Osmani Medical College Hospital, Sylhet, Bangladesh from January 2020 to December 2022 on 30 formalin preserved upper limbs of human cadavers. The external diameter of the radial artery, cephalic vein, and the distance between the radial artery and cephalic vein were measured at the center of the forearm, the anterior part of the wrist, and at the anatomical snuff box (ASB). Measurements were made with a caliper to an accuracy of 0.01 mm. All measurements were tabulated separately for the right and left sides.
Results: Amongst 30 formalin preserved specimens of upper limbs of human cadavers analysed, the diameter of radial artery was 3±0.26 mm on the right-side and 2.87±0.24 mm on the left- side and of cephalic vein was 2.5±0.59 mm on the right-side and 2.9±0.33 mm in ASB. The distance between radial artery and cephalic vein were 2.5±0.59 mm on the right-side and 2.9±0.33 mm on the left-side which was minimum in ASB. The distance between radial artery and cephalic vein was maximum at wrist (4.02±0.76 mm and 4.2±0.71 mm on the right and left hand).
Conclusion: The fistula formation in ASB may give better results as the radial artery and cephalic vein are closer as compared to wrist and midforearm with reasonable diameter. Additionally.