Salvage of a failing dialysis graft by percutaneous creation of a jump bypass graft.
Percutaneous salvage of failing arteriovenous grafts with diffuse disease or occlusion in the venous outflow remains an issue with no ideal solution. The present report describes a method of percutaneous creation of vascular bypasses in a patient with a failing graft. The patient had a long-segment stenosis in the venous outflow of a brachial-cephalic dialysis graft, and the graft was salvaged by conversion to a brachial-basilic graft. Notably, this method allowed the bypass to safely traverse a long distance (20 cm), and at 8 months, the graft remained functional and free of complications. In principle, this approach can be applied to different situations in which superficial bypass conduits are desired.
Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, California 92103, USA. mkuo@ucsd.edu
Michael D
MD
Kuo
Dennis H
DH
Son
Franklin J
FJ
Miller
D000800:Angioplasty, Balloon; D001132:Arm / Q000098:blood supply*; D001166:Arteriovenous Shunt, Surgical; D003097:Collateral Circulation; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D006435:Renal Dialysis; D016879:Salvage Therapy / Q000379:methods; D014680:Veins / Q000503:physiopathology / Q000601:surgery