Gracz fistula is a feasible option after two failed percutaneous arteriovenous fistulae.

The Journal of Vascular Access
Robert ShahverdyanVladimir Matoussevitch

Abstract

Two devices for the creation of an endovascular percutaneous (pAVF) endovascular (endoAVF) arteriovenous fistulae (AVF) are available: the Ellipsys and the WavelinQ-4F systems. The main difference is the location of the anastomosis, making it feasible to use both pAVFs and surgical Gracz-type AVF in an algorithm sequence. A 66-year-old male patient with end-stage kidney disease and HIV was referred for a creation of a dialysis access after failed peritoneal dialysis. A radial-radial WavelinQ-pAVF with simultaneous coil embolization of a brachial vein was created but failed within 4 weeks. Therefore, an Ellipsys-pAVF was successfully created between the proximal radial artery and perforating vein on the same arm. After 2 days, however, the Ellipsys-pAVF anastomosis occluded. The ipsilateral Gracz-AVF was created, anastomosing perforating vein with the antecubital brachial artery. Cannulations were started 28 days later. During the follow up of 807 days, the AVF remained patent with last known volume flow of 1500 ml/min and no need for secondary interventions. We report a successful creation of a Gracz-AVF after primary failed pAVFs created with both pAVF-systems in a single patient and in the same arm. Thus, based on that case w...Continue Reading

References

Jan 1, 1977·Kidney International·K C GraczF K Merkel
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Mar 11, 2017·Techniques in Vascular and Interventional Radiology·Rahul A ShethZubin Irani
Sep 16, 2017·Journal of Vascular Surgery·William C JenningsNasir Mushtaq
Feb 6, 2018·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Michael AllonUNKNOWN Hemodialysis Fistula Maturation (HFM) Study Group
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Aug 15, 2020·Journal of Vascular and Interventional Radiology : JVIR·Robert ShahverdyanWilliam C Jennings

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