Abstract
We report a case of right basilic vein to left external jugular vein venovenous crossover graft against right brachiocephalic vein occlusion. The patient was a 69-year-old woman with end-stage renal disease (ESRD). Hemodialysis (HD) was induced due to chronic glomerular nephritis in 1981. At first, left radio-cephalic arteriovenous fistula (RCAVF) was created on her left forearm, but frequent PTAs and several reconstructive operations were needed against repeated stenosis. Therefore, there was no site for blood access on her left arm, and TBBAVF was created on her right upper arm in 2006. However, it also became completely occluded at the right brachiocephalic vein in November 2014 after repeated stenosis and dilatation with PTA. A right basilic vein to left external jugular vein venovenous crossover bypass graft with vascular prostheses was then created. Blood access was kept patent for over 2 years as of April 2015, though frequent PTAs were needed every 2-7 months. Thus, this operative method can be effective for central vein occlusion in a hemodialysis patient.
