PICC placement and invasion of the nondominant arm are both frequent in patients with abnormal kidney function, in spite of guidelines discouraging their use. The rate of PICC is higher than that of patients with normal kidney function. Current vascular access practices have substantial potential to affect future fistula rates. Effective vein protection may require participation of the entire medical community.

This case shows that percutaneous transluminal angioplasty for an arteriovenous fistula may induce subclavian steal syndrome, and a modified graft inclusion technique was useful in improving the high flow of an arteriovenous fistula.

〔第 656 回関東地方会(2019/12/14)推薦〕 〔受稿 2020/12/24，採用 2021/03/27〕 1) 社会医療法人財団石心会川崎幸病院腎臓内科， 2) 東邦大学医療センター大森病院腎センター， 3) 社会医療法人財団石心会川崎幸病院病理科， 4) 同 心臓外科 Case Report；IgG4-related inflammatory pseudotumor in the left atrium complicated with end-stage kidney disease.

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