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  • Title: Combined femoral vein transposition and iliac vein to suprarenal vena cava bypass as a last resort dialysis access.
    Author: Bellows PH, Anaya-Ayala JE, Cheema ZF, Davies MG, Lumsden AB, Peden EK.
    Journal: Ann Vasc Surg; 2011 Feb; 25(2):264.e5-8. PubMed ID: 20800432.
    Abstract:
    Patients undergoing hemodialysis are known to develop central venous occlusion and exhaust all options for vascular access to upper extremity sites; therefore, creating and maintaining vascular access is paramount in such patients. The present case report describes the condition of a 34-year-old woman with failed upper extremity access, frequent catheter-related issues, and multiple central venous occlusions. As a last resort, access to the lower extremity was pursued as follows: an inferior vena cava bypass was combined with a right femoral transposition fistula and a distal revascularization interval ligation procedure. This complex procedure that was carried out for the purpose of vascular access is a unique, albeit aggressive, surgical solution that resulted in autologous vascular access with a 6-month patency and also served to improve the quality of life in the seemingly hopeless case.
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