Uncommon Surgical Management by AVF between the Great Saphenous Vein and Anterior Tibial Artery for Old Radiocephalic AVF Failure

• Published in: Life (Basel, Switzerland) Switzerland), 2022, Vol.12 (4)
• Main Authors: Kaller, Réka, Mureșan, Adrian Vasile, Arbănași, Emil Marian, Arbănași, Eliza Mihaela, Kovács, István, Horváth, Emőke, Suciu, Bogdan Andrei, Hosu, Ioan, Russu, Eliza
• Format: Report
• Language: English
• ISSN: 2075-1729; 2075-1729
• DOI: 10.3390/life12040529

INTRODUCTIONAutologous native arteriovenous fistula (AVF) created in the non-dominant arm is the gold standard vascular access for dialysis in end-stage renal disease, but the post-surgical vascular access dysfunction causes a reduction in the patient's quality of life. Creating a functional upper extremity permanent arteriovenous access is limited by the upper limb's vascular resources, so good management of a complicated arteriovenous fistula may improve patient outcomes. This article highlights the importance of new surgical options in treating complicated AVFs. CASE REPORTWe present the case of a patient with a 17-year-old complex radio-cephalic arterio-venous fistula and a series of surgical interventions performed for life salvage in the first place and functional vascular access in the second place. Furthermore, we describe a successfully created uncommon type of fistula in the lower extremity between the great saphenous vein and the anterior tibial artery as the last possible access for hemodialysis in this patient. RESULTSThe patient underwent the first successful dialysis using the newly created lower limb fistula 1 month after the surgery. CONCLUSIONApplying new surgical techniques to manage AVFs gives a unique chance to improve the quality of life and reduce morbidity and mortality in these patients.