Axillary Artery to Contralateral Axillary Vein Graft Fistula in Chronic Hemodialysis Patients

Abstract

We conclude that axillary artery to contralateral axillary vein graft fistula may be a feasible alternative choice for chronic hemodialysis access.

Prosthetic axillary-axillary arteriovenous straight access (necklace graft) for difficult hemodialysis patients: A prospective single-center experience

“…15 Our primary and secondary patency rates compared favorably with those reported for other complex accesses or autogenous accesses. 16,17 This series also showed the feasibility of rescue of these grafts with an excellent outcome expressed by the high secondary patency rates. While only one graft was clotted postoperatively due to severe hypotension and successfully rescued, four successful surgical revisions of ruptured grafts after needling and thrombectomy of a further three grafts after long period of use were necessary.…”

“…[21][22][23] Axillary-axillary arteriovenous graft procedures can be complicated by brachial plexopathy and upper limb venous hypertension. 17 However, these complications are reversible and avoidable by thorough work up and cautious dissection. We prefer the radially supported Gore-Tex Intering Vascular Graft because of its ability to withstand difficult angles, even though it could not be used for dialysis for 2 weeks.…”

“…In small series, good results have been shown, and it was advocated for diabetic patients in whom the risk of steal syndrome was high and a lower limb option was too risky. 1,[11][12][13]17 We describe our experience with axillary-axillary arteriovenous bypass graft procedures in a consecutive series of patients.…”

“…Several complex (exotic, extra-anatomic) access procedures in patients with difficult vascular access problems have been described. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] These options include axillary loops, axillaryaxillary arteriovenous grafts, internal jugular vein bypasses, superficial femoral vein transpositions, femorofemoral arteriovenous cross over bypasses, axillary artery to popliteal vein bypasses, and femoral artery to right atrium bypasses. 3,9 The arteriovenous axillary loop graft has been reported as a possible primary vascular access procedure when no other upper limb option is feasible.…”

Hemodialysis Access: Initial Considerations and the Difficult Patient

“…Prosthetic chest and cervical access reports date back to 1978 though the information regarding patency rates and complications is mainly limited to case-based evidence [85][86][87][88]. Described options for chest and cervical A-V access options include: (a) brachial artery to jugular vein access; (b) axillary artery to contralateral axillary or jugular vein; (c) axillary artery to ipislateral axillary vein loop access.…”