The Pipeline Technique: A Simple Endovascular Technique for Creation of a Jump Graft Bypass

Abstract

Purpose The purpose of this study is to describe a technique by which a bypass was created percutaneously with two overlapping covered stents for salvage of a thrombotic right brachial-axillary arteriovenous graft without recanalizable outflow. Methods and results With the pipeline technique, a 16 cm bypass tract covered with two overlapping Viabahn stents between the hemodialysis graft and the right subclavian vein was created as an alternative access outflow. The hemodialysis graft was successfully salvaged without complications and functioned well for more than 6 months except for one thrombosis which occurred 147 days after its salvage. Conclusions We describe an endovascular bypass technique using a sheath-dilator set and two angiographic catheters to salvage a thrombotic hemodialysis graft.