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Percutaneous Extra-Anatomic Double-Barrel Bypass for Salvage of Hemodialysis Access and Treatment of Venous Occlusive Disease

  • Case Report
  • Venous Interventions
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Abstract

A woman with an upper extremity brachioaxillary arteriovenous dialysis graft presented with a 9-month history of profound ipsilateral arm swelling and numbness secondary to chronic axillosubclavian vein occlusion. Previous endovascular and open venous recanalization attempts were unsuccessful. A totally percutaneous extra-anatomic venous bi-bypass was created to salvage the dialysis access circuit and reconstruct the deep venous system. Using overlapping Viabahn stent-grafts, two parallel bypasses were created from the arteriovenous graft and brachial vein, respectively, to the brachiocephalic vein. The hemodialysis graft regained function. Upper extremity symptoms resolved within 48 h. This is the first reported percutaneous double-barrel technique of extra-anatomic venous bypass creation for simultaneous management of a failed dialysis access and chronic venous occlusive disease.

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Abbreviations

AV:

Arteriovenous

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Authors and Affiliations

  1. Division of Interventional Radiology, Department of Radiology, University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA

    Andrew Woerner, David S. Shin, Sandeep S. Vaidya, Sean T. Jones, Eric J. Monroe & Jeffrey Forris Beecham Chick

  2. Division of Vascular Surgery, Department of Surgery, University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA

    Mark H. Meissner

  3. Division of Interventional Radiology, Department of Radiology, Thomas Jefferson University Hospital, 111 South 11th Street, Philadelphia, PA, 19107, USA

    Anthony N. Hage

Authors
  1. Andrew Woerner
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  2. David S. Shin
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  3. Sandeep S. Vaidya
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  4. Sean T. Jones
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  5. Mark H. Meissner
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  6. Eric J. Monroe
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  7. Anthony N. Hage
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  8. Jeffrey Forris Beecham Chick
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All authors have read and contributed to this manuscript.

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Correspondence to Jeffrey Forris Beecham Chick.

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All authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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For this type of study formal consent was not required. Informed consent and family consent were obtained for this procedure and publication.

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Woerner, A., Shin, D.S., Vaidya, S.S. et al. Percutaneous Extra-Anatomic Double-Barrel Bypass for Salvage of Hemodialysis Access and Treatment of Venous Occlusive Disease. Cardiovasc Intervent Radiol 43, 1942–1945 (2020). https://doi.org/10.1007/s00270-020-02615-1

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  • DOI: https://doi.org/10.1007/s00270-020-02615-1

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