Shahverdyan, Robert ORCID: 0000-0002-8352-0954, Konner, Klaus and Matoussevitch, Vladimir . Gracz fistula is a feasible option after two failed percutaneous arteriovenous fistulae. J. Vasc. Access. LONDON: SAGE PUBLICATIONS LTD. ISSN 1724-6032

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Abstract

Two devices for the creation of an endovascular percutaneous (pAVF) endovascular (endoAVF) arteriovenous fistulae (AVF) are available: the Ellipsys and the WavelinQ-4F systems. The main difference is the location of the anastomosis, making it feasible to use both pAVFs and surgical Gracz-type AVF in an algorithm sequence. A 66-year-old male patient with end-stage kidney disease and HIV was referred for a creation of a dialysis access after failed peritoneal dialysis. A radial-radial WavelinQ-pAVF with simultaneous coil embolization of a brachial vein was created but failed within 4 weeks. Therefore, an Ellipsys-pAVF was successfully created between the proximal radial artery and perforating vein on the same arm. After 2 days, however, the Ellipsys-pAVF anastomosis occluded. The ipsilateral Gracz-AVF was created, anastomosing perforating vein with the antecubital brachial artery. Cannulations were started 28 days later. During the follow up of 807 days, the AVF remained patent with last known volume flow of 1500 ml/min and no need for secondary interventions. We report a successful creation of a Gracz-AVF after primary failed pAVFs created with both pAVF-systems in a single patient and in the same arm. Thus, based on that case we recommend creation of pAVF prior to Gracz-AVF as integral part of Vascular Access creation algorithm, based on each patient's life plan.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Shahverdyan, RobertUNSPECIFIEDorcid.org/0000-0002-8352-0954UNSPECIFIED
Konner, KlausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Matoussevitch, VladimirUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-567939
DOI: 10.1177/11297298211021339
Journal or Publication Title: J. Vasc. Access
Publisher: SAGE PUBLICATIONS LTD
Place of Publication: LONDON
ISSN: 1724-6032
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
VASCULAR ACCESS; HEMODIALYSISMultiple languages
Peripheral Vascular DiseaseMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/56793

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