title: Axillary-axillary interarterial chest loop graft for successful early hemodialysis access.
abstract: OBJECTIVE
  Obtaining adequate vascular access in patients undergoing chronic hemodialysis therapy can be demanding, particularly for those in whom all peripheral venous options have been exhausted.
  
  
  METHODS
  We present a case of a 46-year-old woman with a history of complex vascular access for end-stage renal failure for whom there was no remaining possibility of venous access and had reached a palliative stage. We implanted an emergency loop axillary-axillary interarterial early needling graft. Post-operatively, the patient made a quick and uneventful recovery, resuming hemodialysis after only six days with no interventions necessary up to four months follow-up. To the best of our knowledge, this is the first dedicated case report describing the successful implantation of an axillary-axillary interarterial chest loop graft to re-establish access in a patient with exhausted options.
  
  
  CONCLUSIONS
  We recommend the use of this technique to surgeons who find themselves in comparable situations in the future.
authors.affiliation: Department of Vascular Surgery, King's College Hospital, London - UK.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Stephenson
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Norris
authors.forename: Hiren
authors.initials: H
authors.lastname: Mistry
authors.forename: Domenico
authors.initials: D
authors.lastname: Valenti
mesh_terms: D001366:Axillary Artery / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D004630:Emergencies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008875:Middle Aged; D010166:Palliative Care; D011677:Punctures; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome