Percutaneous creation of a venous anastomosis in a native hemodialysis fistula.
The advantages of autogenous fistulas over grafts and catheters for vascular access in hemodialysis are well recognized and include lower rates of all-cause mortality and infection and significantly decreased total access costs. However, a substantial number of fistulas will never mature and are eventually abandoned. Percutaneous techniques are increasingly used to salvage fistulas to enable maturation and use. The authors report on a patient with a thrombosed immature brachiocephalic dialysis fistula with an occluded outflow vein, in whom fistula function was salvaged through creation of a percutaneous vein-to-vein anastomosis. This technique adds to the growing armamentarium of interventional therapies for occluded venous outflow in hemodialysis access sites.
Heller
Samantha L
SL
Section of Vascular and Interventional Radiology, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA.
Clark
Timothy W I
TW
D000714:Anastomosis, Surgical / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome; D014680:Veins / Q000601:surgery*