Salvage of a thrombosed radio-cephalic fistula by anastomosis to brachial comitans vein: A case report.
Marco Taurisano, Cosma Cortese, Andrea Mancini et al.
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Case in brief
A patient with a thrombosed radiocephalic arteriovenous fistula (RCAVF) presented due to inadequate venous outflow, compounded by a non-patent cephalic vein. Surgical intervention involved thrombectomy of the efferent vein and anastomosis to a brachial comitant vein. This approach restored fistula function, allowing successful hemodialysis through the original puncture sites.
What made this case unusual
The use of a brachial comitant vein as a secondary venous outflow for salvaging a thrombosed RCAVF is an innovative approach not previously reported.
Diagnostic / clinical pearl
Clinicians should consider alternative venous conduits, such as brachial comitant veins, for salvaging thrombosed arteriovenous fistulas when traditional options are unavailable.
Why it matters
This case highlights a novel surgical technique that may expand salvage options for patients with thrombosed RCAVFs, particularly in the absence of suitable superficial veins.