The reverse fistula for vascular access.

A new technique for vascualr access in the patient requiring chronic hemodialysis and who has had multiple failures of forearm fistulas involves the formation of a side-to-side anastomosis between the brachial artery and the basilic vein and creates reverse flow into the antecubital venous system. Attention to technical considerations will prevent edema of the arm and allow for future use of graft procedures, if necessary.