Arteriovenous Fistula Salvage Utilizing a Hybrid Vascular Graft

Abstract

Loss of arteriovenous fistula as access for hemodialysis leads to significant morbidity and increased mortality risk. Maintenance of this access is of paramount importance and we describe a case of a patient with a functioning radiocephalic fistula with associated arm swelling due to poor narrow caliber venous drainage above the elbow but with normal central veins. A hybrid vascular graft was anastomosed to the upper extent of the fistula and the nitonol stent section introduced into the patent axillary vein. The described method led to resolution of symptoms and arm swelling. The described method allowed the continued use of a mature fistula.