Graft to Vein Fistula with Partial Thrombosis: A Case Report and Literature Review

Abstract

Hemodialysis (HD) remains the chosen treatment for patients with kidney failure. Arteriovenous fistula (AVF) remains the preferred access over arteriovenous graft (AVG), but AVG is used as crucial alternative access for patients who cannot have an AVF created. AVG complications include infection, aneurysm, thrombosis, steal syndrome, and graft to vein fistula (GVF). GVF can reduce the blood flow to the AVG, leading to frequent thrombosis. We report a case of a 62-year-old patient with end-stage renal disease (ESRD) on hemodialysis for two years, whose AVG has a functional iatrogenic fistula occasionally created by cannulation. Partial thrombosis was found in the venous limb of the AVG under sonogram analysis. We finally chose to leave GVF as an alternative HD access without further intervention after careful examination. This new vascular access, formed from GVF and the arterial limb of AVG, maintains patency for more than one year without significant complications. It may change the practice pattern of GVF in the future.