Arterio-Arterial Graft Interposition and Superficial Femoral Vein Transposition: An Unusual Vascular Access

After years of hemodialysis we happen to be dealing with the unusable veins and requiring a vascular access. Two solutions can be proposed: the arterioarterial graft interposition or the superficial repositioning of the superficial femoral vein (SFV). We carry out 350 to 400 hemodialysis vascular accesses per year. Only 16 exceptional accesses have been realised. 7 patients have had superficial transposition of SFV. Complications observed: 1 low debit by obliteration of femoral artery treated by femoral bypass and 3 cases of thromboses (1,4 and 5 years). They either had a simple thrombectomy or one with prosthesis interposition. 9 patients had arterioarterial graft (3 brachial arteries and 6 Subclavian arteries); postoperative complications consisted of necroses skin and prosthesis infection, two precocious two thromboses of the graft (6 and 10 days) they made the subject of a thrombectomy and bleeding in the 5 th month, which required a suture. Patients had hemodialysis for 5 to 132 months. The middle length of permeability of the access was of 57 months for the superficialization of the SFV and 18 months for the arterioarterial graft. The exceptional accesses are an alternative for patients that do not have the possibility of a conventional vascular access.