Alternative Venous Outflow by Brachial to Jugular Vein Vascular Access for Hemodialysis in the Exhausted Upper Extremities

Kim, Myoung Jo; Yun, Sangchul; Song, Dan; Cho, Sung Woo; Goo, Dong Erk; Kim, Yong Jae; Choi, Dongho

doi:10.5301/jva.5000363

Cited by 3 publications

(2 citation statements)

References 27 publications

(29 reference statements)

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“…The external jugular vein was identified as a viable outflow conduit for arteriovenous fistulas of the upper extremity in cases where the axillary veins are occluded, exhibiting acceptable patency rates (9). In another study, the use of an ipsilateral internal jugular vein (IJV) as an AV outflow vein was examined in patients with subclavian or axillary vein stenosis or occlusion (10). The results indicated that a brachialjugular AV graft may achieve satisfactory results in terms of patency and complication rate, although the primary patency rate decreases significantly over time.…”

Section: Introductionmentioning

confidence: 99%

“…The results indicated that a brachialjugular AV graft may achieve satisfactory results in terms of patency and complication rate, although the primary patency rate decreases significantly over time. The use of the IJV as an outflow vein should be the last option for using a particular arm due to the risk of complications such as steal syndrome, seroma, hematoma, swollen arm, infections, pseudoaneurysm, bleeding from puncture site, stenosis and thrombosis (10). In the present case, a prosthetic AV loop between the brachial artery (BA) and the EJV was used for a patient whose vascular conditions did not allow for the creation of another type of upper limb access.…”

Section: Introductionmentioning

confidence: 99%

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Prosthetic brachial artery-external jugular vein arteriovenous grafts as a novel option for hemodialysis access: A case report

Lei,

Lai,

Xin

2023

Exp Ther Med

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Following the exhaustion of all conventional hemodialysis access options in the upper extremities, a prosthetic arteriovenous loop was performed between the brachial artery (BA) and the external jugular vein (EJV) as a novel access option for hemodialysis in the present case report. During the procedure, a polytetrafluoroethylene graft was anastomosed to the BA and the EJV, and looped on the upper limb. The safety and reliability of BA-EJV access was evaluated by determining the complications, patency and intervention rates. The patient was then followed up for 20 months. The graft became thrombosed 20 months after the placement. There were no complications, such as infection, bleeding or aneurysmal lesions. Overall, the present study demonstrates that hemodialysis via BA-EJV access represents an unusual, yet effective and safe procedure, which may be conducted with acceptable complications and patency rates.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prosthetic brachial artery-external jugular vein arteriovenous grafts as a novel option for hemodialysis access: A case report

Lei,

Lai,

Xin

2023

Exp Ther Med

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Prevalence of thrombosis in patients undergoing dialysis treatment: A systematic review and meta-analysis

Shiri,

Rezaeian,

Abdi

et al. 2024

Journal of Vascular Nursing

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Pathophysiology of High Flow Access and Surgical Flow Reduction Procedures

Nojima

Motomiya

2021

Kidney and Dialysis

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High flow access (HFA) is a condition in which hemodynamics is affected by a flow rate that is larger than the blood flow required for hemodialysis. HFA sometimes causes high output heart failure, venous hypertension, and dialysis access steal syndrome. Flow reduction is effective for improving symptoms, and various surgical procedures have been reported. HFA is recognized as a well-developed type of access due to its good access sound, thrill, and vessel diameter; also, HFA probably has good patency if not intervened with by flow reduction. Therefore, the blood flow reduction procedures used to treat HFA need to minimize disadvantages such as access thrombosis, insufficient blood flow, aneurysm formation, and infection due to therapeutic intervention while, at the same time, achieving symptom improvement and long-term patency. The surgical procedure used to correct HFA must be highly reproducible and simple. This article reviews the pathophysiology and surgical flow reduction procedures for HFA.

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Alternative Venous Outflow by Brachial to Jugular Vein Vascular Access for Hemodialysis in the Exhausted Upper Extremities

Abstract: A brachial-jugular AV graft showed satisfactory results in terms of patency and complication rate. The IJV could be a good outflow vein for an AV fistula if the IJV is preserved in patients with chronic renal failure who have subclavian or axillary vein stenosis or occlusion.

Cited by 3 publications

References 27 publications

Prosthetic brachial artery-external jugular vein arteriovenous grafts as a novel option for hemodialysis access: A case report

Prosthetic brachial artery-external jugular vein arteriovenous grafts as a novel option for hemodialysis access: A case report

Prevalence of thrombosis in patients undergoing dialysis treatment: A systematic review and meta-analysis

Pathophysiology of High Flow Access and Surgical Flow Reduction Procedures

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