Complex reconstruction of arteriovenous fistula for hemodialysis

We report a complex reconstruction of arteriovenous fistula (AVF). Proximal stenosis of cephalic vein was followed by aneurysms of fistulous veins (distal segment of cephalic vein and median cubital vein) complicated by AVF thrombosis. Blood outflow from AVF was retrograde. One week after thrombosis, an aneurysm of median cubital vein containing dense clots was excised. We resected cephalic vein wall and repaired the vessel. Anastomosis with the brachial artery was created distal to the last anastomosis. Proximal cephalic vein repair was performed using resected aneurysm walls. After a year, AVF has been successfully used for hemodialysis.