[Axillo-axillary access in hemodialysis]

Area of Science:

• Vascular Surgery
• Nephrology
• Dialysis Access

Background:

• Upper arm peripheral veins are often impracticable for dialysis access.
• Previous arteriovenous fistulas may be thrombosed, necessitating alternative solutions.
• Axillo-axillary angio-access offers a potential alternative in challenging cases.

Purpose of the Study:

• To evaluate the efficacy and safety of axillo-axillary angio-access in dialysis patients.
• To assess the patency rates and clinical outcomes of this specific vascular access.
• To determine the suitability of axillo-axillary grafts when other options fail.

Main Methods:

• Retrospective analysis of seven dialysis patients.
• Inclusion of patients with impracticable upper arm veins or thrombosed fistulas.
• Utilized bovine or synthetic grafts for axillo-axillary angio-access.

Main Results:

• Forty-one angio-access procedures were performed in the seven patients.
• One immediate failure was observed.
• High patency rates were achieved, lasting until patient death or successful renal transplantation.
• Excellent clinical and hemodynamic tolerance was reported.

Conclusions:

• Axillo-axillary angio-access is a successful alternative for hemodialysis.
• The procedure shows high patency and excellent patient tolerance.
• It is a valuable option for patients with limited upper limb vascular access.