A bovine shunt, inserted between the radial artery and cephalic vein in the upper arm for access during chronic haemodialysis, caused a distal, ischaemic neuropathy in two patients. There were electrophysiological signs of axonal degeneration of motor and sensory nerve fibres in the patient with severe ischaemia, and, of only sensory fibres in the patient with mild ischaemia. Thenar muscle blood flow studies using 133Xe were a useful measure of altered tissue perfusion. Recovery was incomplete in both cases, despite banding of the graft and improved tissue perfusion in the severe case.
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