title: Unusual sites for hemodialysis vascular access construction and catheter placement: A review.
abstract: As more end-stage renal disease patients require hemodialysis and live longer, many will fail to develop or maintain a functioning upper extremity vascular access. When a patient exhausts vascular access sites in the upper extremities, new fistulas and grafts can be constructed in the lower extremities, thorax, and abdomen as long as a pair of proximate artery and vein provide adequate blood inflow and outflow, respectively. When only a moderate size vein with adequate blood flow provides a conduit to either a patent superior or inferior vena cava, inserting a double-lumen venous hemodialysis catheter can provide temporary or permanent access. We review the literature and report the unusual sites for hemodialysis vascular access and catheter placement.
authors.affiliation: 1 Division of Renal Diseases and Hypertension, Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC - USA.
authors.forename: Susie Q
authors.initials: SQ
authors.lastname: Lew
authors.forename: Bao-Ngoc
authors.initials: BN
authors.lastname: Nguyen
authors.forename: Todd S
authors.initials: TS
authors.lastname: Ing
mesh_terms: D002408:Catheters, Indwelling; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D006435:Renal Dialysis / Q000379:methods*; D034941:Upper Extremity / Q000098:blood supply*