The journal of vascular access
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Case Reports
Hybrid management of a false aneurysm complicating an arteriovenous graft in a patient with critical limb ischemia.
End-stage renal diabetic patients undergoing dialysis through an arteriovenous graft (AVG) often present with multiple graft complications which demand a combined therapeutic approach. We report a case of a male suffering from a pseudoaneurysm and venous outflow stenosis of his thigh AVG, as well as from critical limb ischemia caused by multiple significant stenoses of the femoropopliteal arterial segment. ⋯ This case illustrates the prospect of combining classic open surgical and endovascular techniques for the optimal management of complicated AVGs. Using the hybrid approach in these cases one can succeed in optimizing the result, while simultaneously minimizing the overall risk for the patient.
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Patency of the left superior vena cava (persistent left superior vena cava--PLSVC), although uncommon, is the most frequent anomaly of the thoracic vessels. It has been diagnosed in 0.3-0.5% of the general population. ⋯ We present the case of a 50-year-old HD patient in which the placement of a catheter through the left internal jugular vein, needed for HD treatment, revealed a PLSVC. After the demonstration of adequate draining of the vessel into the right atrium, replacement of this catheter for a cuffed tunneled HD catheter was done, which has since been used successfully for HD.