Superficialization, as the name suggests, means moving the vessel to a more superficial layer.
It is commonly done for a native fistula at the elbow or upper arm, the brachio-basilic arteriovenous fistula (BBAVF).
A well-functioning fistula after surgery has a clearly audible blood-flow sound, and a clear thrill can be felt at the elbow.
But no large vessel is visible on the surface, which makes it difficult for dialysis nurses to needle.
On ultrasound, the vessel (the basilic vein) is found to have a large diameter but to lie too deep beneath the skin.
A depth of more than 6 mm usually makes needling difficult.
The vascular surgeon therefore performs an operation to move the deep vessel to a more superficial position, making later needling for dialysis easier.
