Use of the Superficial Femoral-Popliteal Vein to Salvage Dialysis Access

Abstract

Long-term angioaccess for patients with chronic renal failure remains a serious challenge for the vascular surgeon. This report is of a 69-year-old man who had a well-functioning left Brescia fistula at the time of his pacemaker placement for life-threatening cardiac dysrhythmias. Following pacemaker placement, the patient developed left arm swelling, which involved the entire upper limb and failure of the hemodialysis access secondary to a left subclavian vein stenosis. After failed attempts at angioplasty and other endovascular procedures, the patient underwent successful placement of a left axillary vein to left internal jugular vein interposition graft using the left superficial femoral popliteal vein to salvage the dialysis access.

Get full access to this article

View all access options for this article.

References

1. Stanley JC , Barnes RW , Ernst CB , et al: Vascular surgery in the United States: Workforce issues. Report of the Society for Vascular Surgery and the International Society for Cardiovascular Surgery, North American Chapter, Committee on Workforce Issues. J Vasc Surg 23:172-181, 1996.

2. el-Nachef MW , Rashad F , Ricanati ES : Occlusion of the subclavian vein: A complication of indwelling subclavian venous catheters for hemodialysis. Clin Nephrol 24:42-66, 1985.

3. Bhatia DS , Money SR , Ochsner JL , et al: Comparison of surgical bypass and percutaneous balloon dilatation with primary stent placement in the treatment of central venous obstruction in the dialysis patient: Oneyear follow-up. Ann Vasc Surg 10:452-455, 1996.

4. Sottiurai VS , Lyon R , Ross C , et al: Surgical management of brachioaxillary-subclavian vein occlusion. Eur J Vasc Endovasc Surg 11:225-229, 1996.

5. Fulks KD , Hyde GL : Jugular-axillary vein bypass for salvage of arteriovenous access. J Vasc Surg 8:169-171, 1988.

6. Schulman ML , Badhey MR , Yatco R , et al: An 11-year experience with deep leg veins as femoropopliteal bypass grafts. Arch Surg 121:1010-1015, 1986.