A new access, Dermatorrhea, 10 samples of the great saphenous vein

We devised a method that enables blood removal/return by creating a fistula between the skin and the great saphenous vein to insert the dialysis needle sheath in the femoral vein under ultrasonography guidance with respect to each dialysis. We report the principles, methods, and cases. A skin-great saphenous vein fistula is created under local anesthesia. It is used for blood removal/return during maintenance hemodialysis performed immediately after creating the fistula. Ten limbs of 10 patients (three men and seven women; mean age, 77.6 ± 4.8 years; dialysis history, 9.9 ± 13.0 years), where skin-great saphenous vein fistulas were created in our hospital between May 2017 and June 2018, were included. In all the cases, an arteriovenous fistula or arteriovenous graft was difficult to create because of the general condition and/or vascular fitness of the patients. During or after the fistula-creating surgery, no serious complications were found. No complications such as blood removal failure, infection, or hemorrhage were found during the follow-up period. The primary patency rates by the Kaplan-Meier method were 100% at 3 months and 67.5% at 6 months. This method is considered a valuable substitute method for cases with difficulty in creating a vascular access.