KARL D. NOLPH, M.D., F.A.C.P.
Chronic intermittent extracorporeal hemodialysis became practical with the development of the external arteriovenous shunt by Quinton, Dillard, and Scribner in 1960 (1). With the use of these Teflon, later Silastic-Teflon and recently all Silastic, cannulae, thousands of patients have received this life-sustaining therapy in the past decade. Uncomplicated shunts have minimal effects on cardiac output and, aside from the inconvenience of avoiding trauma or wetting of the shunt area, are well tolerated. Mean shunt survival has been reported by some centers to be as high as 12 to 14 months (2).
Yet the shunt that made chronic dialysis possible has
KARL D. NOLPH. External Shunts and Internal Fistulas. Ann Intern Med. 1971;74:1008–1009. doi: 10.7326/0003-4819-74-6-1008
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Published: Ann Intern Med. 1971;74(6):1008-1009.
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