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Updated: Apr 25, 2026
Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
Published on: April 1, 2022
Extending the longevity of a complicated arteriovenous fistula using endovascular intervention
B Pawar1, K Fernandes1, C T Sajiv1
1Department of Renal Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.
Insights
A brachiocephalic arteriovenous fistula complication was treated with a cephalojugular bypass graft. Endovascular intervention successfully addressed graft stenoses, extending vascular access longevity.
Area of Science:
- Vascular Surgery
- Interventional Radiology
Background:
- Brachiocephalic arteriovenous fistulas are crucial for hemodialysis access.
- Central venous stenosis can complicate fistula creation and function.
Observation:
- A patient developed central venous stenosis unresponsive to initial treatment.
- A subsequent cephalojugular bypass graft developed critical stenoses at both graft ends.
Findings:
- Endovascular intervention, specifically angioplasty and stenting, was employed to treat the graft stenoses.
- The endovascular approach successfully relieved the stenoses, restoring graft patency.
Implications:
- Endovascular treatment offers a viable solution for managing cephalojugular bypass graft stenoses.
- This approach can prolong the functional life of challenging vascular access.
- Successful management of complex venous stenosis is critical for maintaining hemodialysis access.
Abstract:
A brachiocephalic arteriovenous fistula was complicated by a central venous stenosis, which could not be relieved. A cephalojugular bypass was performed using an interpositoned graft, which later developed tight stenoses at both ends of the graft. This was successfully treated with endovascular intervention, extending the longevity of the vascular access.
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