Staged surgical salvage of an abandoned hemodialysis graft due to small inflow artery variant

Abstract

Based on the patient’s life planning, arteriovenous fistula (AVF) and arteriovenous graft (AVG) is better than tunnel-cuffed catheter (TCC) due to catheter-related central venous disease. However, the successful establishment of AVF or AVG requires sufficient vascular conditions. This case report described the reconstruction of an abandoned AVG in a young patient with a small-caliber and high bifurcation artery that was initially unsuitable for AVG creation. We designed a procedure in which an AVF was first established to achieve arterial dilation, and after sufficient enlargement of the artery in a few days, the abandoned graft was reutilized by graft interposition in arterial and venous side separately. We salvaged an AVG by using a simple and inexpensive method to create sufficient arterial condition for AVG establishment making a young patient able to transition from a TCC to an AVG.