Vascular access (VA) maintenance is challenging in complex dialysis patients, where patient-centered approaches are decisive. Arteriovenous grafts (AVGs) provide an alternative for those unsuitable for autogenous arteriovenous fistula (AVF). However, AVFs and AVGs are prone to complications such as stenosis, aneurysm, and thrombosis, leading to dysfunction and morbidity in these patients. This report focuses on the journey of an extraordinary longevity of a 15-year-old AVG in a 54-year-old female patient, detailing multiple interventions required to maintain its patency. The case also underscores the role of a multidisciplinary team in achieving long-term success.
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