TY  - JOUR
T1  - RAdiography of the av shunt in hemodialysis
AU  - Chinitz J, Onesti G, Brest AN, Swartz C
Y1  - 1969/03/24
N1  - 10.1001/jama.1969.03150250116032
JO  - JAMA
SP  - 2286
EP  - 2286
VL  - 207
IS  - 12
N2  - To the Editor:— 
    Cannula failure continues to be a most vexing problem in maintenance dialysis. While this has prompted a trend toward the use of internal arteriovenous fistulae1,2 it has also stimulated efforts toward improvement in shunt design.3,4 To determine causes for progressive decrease in shunt flow or recurrent episodes of cannula clotting we have performed shunt contrast arteriography and venography in straight shunts with standard x-ray contrast media, methylglucamine diatrozoate-60%. Venous injection was well tolerated but rapid manual arterial injection was associated with excruciating burning pain of such a disagreeable nature that patients either outrightly refused repeat study or pleaded for general anesthesia. Five percent sodium chloride and 20% mannitol solutions gave identical pain on arterial injection. To minimize discomfort we diluted the contrast material with sterile distilled water in a three to one ratio, resulting in a 15% solution of methylglucamine diatrozoate with an osmolarity of
SN  - 0098-7484
M3  - doi: 10.1001/jama.1969.03150250116032
UR  - http://dx.doi.org/10.1001/jama.1969.03150250116032
ER  -