the cephalic vein was identified and was skeletonized along its distal 5 cm in the arm, dissection being carried as distally as possible. The tendonous aponeurosis of the biceps was then incised and the brachial artery was exposed and was encircled with a vessel loop. The patient was given heparin intravenously.
The cephalic vein was ligated at its most distal end and was brought into the arterial side of the operative field. Vascular clamps were used to obtain control of the brachial artery and a 6 mm longitudinal arteriotomy was then made with a 11 blade. Stay sutures were placed. The end of the vein was slightly spatulated to match the size of the arteriotomy. The arterio-venous anastomosis was then performed with 6-0 prolene, in a continuous running manner. At the completion the artery was back and forward flushed., and the sutures were tied.