On the Artificial Kidney IV.

Beyond the Veins: Uncovering the History and Advancements of Vascular Access

“…Alwall developed the concept of a bypass using a rubber tube coated with silicone to connect the artery and vein. 2 This method was later discontinued because of high rates of thrombosis and infection until the advent of polytetrafluoroethylene (PTFE). In 1960, the Quinton-Scribner shunt modified Alwall's bypass technique using two thin-walled PTFE cannulae with tapered ends inserted into the radial artery and cephalic vein, which were connected by an external PTFE tube, 3 making maintenance HD possible by providing sufficient blood flow during HD.…”

The arteriovenous fistula and the history of a forgotten pioneer

“…14 Alwall's method was discontinued due to a high risk of thrombosis and infection. 14,15 Alwall's bypass method was further developed by Wayne Quinton, David Dillard, and Belding Scribner, who used polytetrafluorethylene (PTFE) tubing instead of glass to forego the use of heparin in preventing thrombosis. 16 Quinton, Dilllard, and Belding created an arteriovenous shunt from the radial artery to the cephalic vein that was externalized from the body, and could be replaced by a dialyzer during dialysis treatments.…”

Haemodialysis and Vascular Access in the End Stage Kidney Disease

“…Initially, vascular access methods relied on repeated peripheral cannulation to deliver arterial blood to the dialysis machine and return it to an accompanying vein. In 1949, Alwall, made the first attempt to connect an artery and a vein, using glass cannula and rubber tubing [6,19]. This device would allow blood to be diverted onto an extracorporeal circuit for dialysis when required.…”