Proximalization of Arterial Inflow for the Treatment of Limb Ischemia in a Transposed Femoral Arteriovenous Fistula—A Case Report

Author:

Veterano Carlos Filipe Pinho1ORCID,de Almeida Paulo Jorge Carvalho12,Rego Duarte Nuno Cunha12,Loureiro Luís Pedro Martins Macedo Alvarenga123,Pinto Pedro Jorge Sá12,Machado Rui Manuel Vieira Mota123

Affiliation:

1. Angiology and Vascular Surgery Department Centro Hospitalar Universitário de Santo António Porto Portugal

2. Kidney Transplantation Unit Centro Hospitalar Universitário de Santo António Porto Portugal

3. Surgery Unit Instituto Ciências Biomédicas Abel Salazar Porto Portugal

Abstract

ABSTRACTIntroductionFemoral vein transposition is one of the final resorts for vascular access in patients with exhaustion of upper limb venous patrimony and central venous occlusive disease. Its major pitfalls include hemodialysis access‐induced distal ischemia and infection. Surgical procedures may be warranted to preserve vascular access if ischemia develops. Several techniques are reported in the literature for femoral vein transposition.Case ReportWe expose an endoscopic femoral vein harvesting as an alternative to the single thigh incision in order to avoid its associated complications. In the setting of ischemia, proximalization of arterial inflow was used to manage femoral vein transposition associated limb ischemia.ConclusionThis case report aims to expose the aforementioned unreported surgical techniques for lower limb arteriovenous fistula, its advantages, and pitfalls, as well as considerations on its future use.

Publisher

Wiley

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