title: Carotid-brachial bypass and simultaneous radiocephalic fistula for a patient on hemodialysis.
abstract: Patients undergoing long-term hemodialysis often suffer from obliterative arterial disease, which may lead to hand ischemia and/or access failure. We present the case of a 54-year-old female patient with multiple failures in obtaining vascular access. Computed tomography angiogram revealed a long occlusion of the axillary artery. Vein mapping through duplex scanning demonstrated a suitable cephalic vein in the left forearm. A left carotid-brachial bypass was performed with simultaneous radiocephalic arteriovenous fistula formation. Immediate results were excellent, and the postoperative course was uneventful. To our knowledge, this is the first report of such a combined approach.
authors.affiliation: Department of Vascular Surgery, Institut Mutualiste Montsouris, Paris, France. wallabass@yahoo.com
authors.forename: Willy
authors.initials: W
authors.lastname: Yankovic
authors.forename: Alexandros
authors.initials: A
authors.lastname: Mallios
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Rafati
authors.forename: Alessandro
authors.initials: A
authors.lastname: Costanzo
authors.forename: Benoit
authors.initials: B
authors.lastname: Boura
authors.forename: Myriam
authors.initials: M
authors.lastname: Combes
mesh_terms: D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging; D001166:Arteriovenous Shunt, Surgical; D001366:Axillary Artery / Q000000981:diagnostic imaging; D019917:Blood Vessel Prosthesis Implantation; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006435:Renal Dialysis; D014057:Tomography, X-Ray Computed; D034941:Upper Extremity / Q000098:blood supply*