title: A rare variant route of the ulnar artery does not contraindicate the creation of a fistula in the wrist of a diabetic patient with end-stage renal disease.
abstract: A superficial variant route of the ulnar artery is a rare variation of the arterial system of the wrist. The route of the arteries in that region is extremely important for patients with end-stage renal disease due to the necessity to create an arteriovenous fistula for hemodialysis. It is thought that the vascular access is too often achieved by catheters or vascular prostheses because of that each possibility to create a fistula in the wrist region should be utilized. In our patient a rare variant route of the ulnar artery was observed in the wrist region. Instead of a deep route between the muscles the artery did not only run superficially, but, also untypically, first laterally and then medially. A variation of the ulnar artery's route may evoke a fear of hand ischemia after creation arteriovenous fistula for hemodialysis. The fear may be connected with blood supply throw the palmar arch which is created by radial and ulnar artery. This fear of the doctor may result in avoiding the attempt to create an arteriovenous fistula on the wrist. The authors demonstrate that the variant route of the ulnar artery is not a contraindication to the creation of a fistula on the wrist using the radial artery because of a fear of hand ischemia.
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland. m.banasik@interia.pl
authors.forename: Mirosław
authors.initials: M
authors.lastname: Banasik
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Madziarska
authors.forename: Wacław
authors.initials: W
authors.lastname: Weyde
authors.forename: Mariusz
authors.initials: M
authors.lastname: Kusztal
authors.forename: Tomasz
authors.initials: T
authors.lastname: Gołębiowski
authors.forename: Sławomir
authors.initials: S
authors.lastname: Zmonarski
authors.forename: Magdalena
authors.initials: M
authors.lastname: Krajewska
authors.forename: Dariusz
authors.initials: D
authors.lastname: Janczak
authors.forename: Marian
authors.initials: M
authors.lastname: Klinger
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D003920:Diabetes Mellitus / Q000628:therapy*; D006801:Humans; D007511:Ischemia / Q000517:prevention & control; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D016896:Treatment Outcome; D017535:Ulnar Artery / Q000002:abnormalities* / Q000601:surgery; D054079:Vascular Malformations; D014953:Wrist / Q000098:blood supply / Q000601:surgery