Superficialization of segmentally matured brachial vein complex as the last possible native, upper arm vascular access for hemodialysis

The Journal of Vascular Access
Stanisław PrzywaraTomasz Zubilewicz

Abstract

We present a case report on superficialization of the segmentally matured brachial vein complex as the last possible native vascular access for hemodialysis in the upper arm. A 57-year-old, female patient was hemodialysed for 14 years. Due to multiple failures of her previous forearm and upper arm vascular access for hemodialysis, the last attempt at the creation of upper arm native vascular access was planned in terms of the formation of a two-stage autogenous brachial-brachial arterio-venous fistula (ABBA). The second stage exposure of the brachial vein - 4 weeks after anastomosis with the brachial artery showed an unusual intraoperative situation. Segmental maturation of both brachial veins, connected by a bridging vein was encountered. Both the mature segments of the brachial veins, connected by the bridging vein were elevated/superficialized into a subcutaneous bed. Immature parts of brachial veins were left near their anatomical position. Superficialized venous conduit was easily accessible and provided adequate parameters of uncomplicated hemodialysis for 6 months. In month 7, thrombosis of the fistula caused by an embolus due to an atrial fibrillation episode required thrombo-embolectomy. The fistula is still in use 13 ...Continue Reading

References

Jun 26, 2004·Journal of Vascular Surgery·Hernan A Bazan, Harry Schanzer
Sep 8, 2007·Annals of Vascular Surgery·Hossam A ElwakeelIbrahim Awad
Feb 5, 2008·Journal of Vascular Surgery·Kevin CaseyW Charles Sternbergh
Oct 31, 2008·Journal of Vascular Surgery·Joshua I GreenbergNiren Angle
Dec 15, 2010·Journal of Vascular Surgery·Javier E Anaya-AyalaEric K Peden
May 13, 2014·The Journal of Vascular Access·Mariusz KusztalWaldemar Letachowicz

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