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.
Kuo
Michael D
MD
Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, California 92103, USA. mkuo@ucsd.edu
Son
Dennis H
DH
Miller
Franklin J
FJ
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