Abstract
A 65-year-old male was initiated on hemodialysis through a radio-cephalic arteriovenous fistula. He required a proximal brachiocephalic fistula due to a failing radiocephalic fistula. Both fistulae could be functionalized simultaneously due to a forearm cephalic perforator vein. The radiocephalic fistula was subsequently ligated, allowing the patient to use the mature brachiocephalic fistula instead of a bridging temporary/tunneled catheter.
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