Percutaneous Creation of a Jump Bypass Graft in a Native Arteriovenous Hemodialysis Fistula

The Pipeline Technique: A Simple Endovascular Technique for Creation of a Jump Graft Bypass

“…They did not report any stent-related complications during the 9-month follow-up. Timpone et al (4) placed a Viabahn stent, which is the same as that used in our case, and reported no stent-related complications during the follow-up. Miller et al (5) reported one stent migration and one stent fracture during the follow-up.…”

“…Kuo et al (3) created a 20 cm stented bypass using a tunneler and two controlled venous puncture sites. Timpone et al (4) used the technique of Kuo et al (3) and created a 7 cm stented bypass for salvaging a dysfunctional autogenous fistula. In the tunneler technique (3, 4), after a subcutaneous tunnel is created, the main guide wire is initially left in the tunnel.…”

“…Timpone et al (4) used the technique of Kuo et al (3) and created a 7 cm stented bypass for salvaging a dysfunctional autogenous fistula. In the tunneler technique (3, 4), after a subcutaneous tunnel is created, the main guide wire is initially left in the tunnel. Both ends of the wire are then advanced into the recipient's vein and the access body separately via two peel-away sheaths.…”

“…Both ends of the wire are then advanced into the recipient's vein and the access body separately via two peel-away sheaths. After this, the hard end of the main wire is snared out of the retrograde sheath in the recipient vein (3) or the antegrade sheath (4) in the access body to obtain through-and-through wire access. Kuo et al's technique (3) allowed interventionists to make a longer and customized subcutaneous tract that could accommodate bends or curves.…”

“…This is achieved by creating a bypass, which is usually performed surgically. Techniques for percutaneous creation of a bypass in the treatment of thrombotic or dysfunctional hemodialysis vascular access (1357), an endovascular bypass (6), have been previously reported (Tab. I).…”