Left common iliac artery to inferior vena cava abdominal wall arteriovenous graft for hemodialysis access

• Published in: Journal of vascular surgery 2012-08, Vol.56 (2), p.489-491
• Main Authors: Zamani, Nader, BS, Anaya-Ayala, Javier E., MD, Ismail, Nyla, PhD, Peden, Eric K., MD
• Format: Article
• Language: English
• Subjects: Anemia, Sickle Cell - complications; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Arteriovenous Shunt, Surgical - methods; Biological and medical sciences; Blood Vessel Prosthesis Implantation; Emergency and intensive care: renal failure. Dialysis management; Female; Humans; Iliac Artery - surgery; Intensive care medicine; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - etiology; Kidney Failure, Chronic - therapy; Medical sciences; Middle Aged; Renal Dialysis; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Thrombophilia - complications; Upper Extremity Deep Vein Thrombosis - complications; Vascular Diseases - complications; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Vena Cava, Inferior - surgery
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2012.01.062

We describe a novel arteriovenous graft configuration in the abdominal wall for hemodialysis in a 51-year-old woman with sickle cell disease. Upper extremity access sites were exhausted, and intrathoracic central veins occluded. Because of diminished quality of the left groin due to scar tissue from previous infected access, inadequate vasculature, and the presence of functional femoral catheter in the right groin with common iliac vein stenosis, we decided to create an arteriovenous graft from the left common iliac artery to the inferior vena cava. Adequate thrill and uneventful postoperative recovery was observed. At 4 months, the patient has been successfully using her graft.