In three patients in need of long-term hemodialysis four long arteriovenous shunts were constructed by anastomosing the distal end of the proximal segment of the saphenous vein divided below the knee to the common femoral artery. The "arterialized" vein lying subcutaneously in the thigh has provided satisfactory access for recurrent hemodialysis for many months. In one patient perivascular fibrosis recurring after 23 months required a second shunt.