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  • Shunts designed to create a graft fistula, a passage between an artery and a vein (typically in an arm), that provides access for hemodialysis procedures. These shunts typically consist of a synthetic (e.g., polytetrafluoroethylene, Dacron) tube with a thin wall and appropriate size (6 mm [0.25 inch] in diameter is the most common) and configuration to facilitate puncturing. A hollow tunneler is used to implant the shunt under the skin; a straight shunt is placed between the radial artery and the antecubital vein, and a loop shunt is placed between the brachial artery and the antecubital vein. Arteriovenous shunts are used for hemodialysis procedures when it is not possible or convenient to create a direct fistula between an artery and a vein. Percutaneous shunts (e.g., Quinton-Scribner, Thomas) intended for arm and/or leg use are no longer frequently used for hemodialysis.
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