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May 31, 2026Journal of Korean Dialysis Access0 citationsOpen Access

Antegrade Wire-Guidance During Retrograde Access of a Thrombosed Hemodialysis Fistula: A Case Report

SPSuyoung Park

Key Points

  • To illustrate the use of antegrade wire guidance in overcoming challenges related to retrograde access in thrombosed hemodialysis fistulas.
  • Patient had a thrombosed right brachiocephalic arteriovenous fistula with absent flow.
  • Transfemoral access was obtained for retrograde cannulation, which was unsuccessful due to collateral veins.
  • A 0.018-inch guidewire was used to facilitate the retrograde cannulation process.
  • Antegrade wire guidance was successfully used to overcome limitations of retrograde access.
  • Thrombosed hemodialysis access was punctured directly with improved outcomes.
  • The attempt demonstrated an innovative approach for managing hemodialysis fistula dysfunction.

Abstract

A 67-year-old man with a history of right brachiocephalic arteriovenous fistula creation and proximal cephalic veinto-axillary vein graft transposition performed 10 years earlier was referred for angioplasty due to arteriovenous fistula dysfunction.Ultrasound demonstrated a thrombosed access site with absent flow.Transfemoral access was obtained, and retrograde cannulation was attempted; however, the procedure was unsuccessful due to multiple collateral veins.A thrombosed hemodialysis access route was then punctured, and a 0.018-inch guidewire was inserted and used as a landmark to facilitate retrograde cannulation.We report this case in which the limitations of retrograde access were overcome using antegrade wire guidance.

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Cite This Study

Suyoung Park (2026) studied this question.

synapsesocial.com/papers/6a1bcfb05783ba022b6fbad0https://doi.org/10.56774/jkda26003
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Also Consider

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  1. 1Endovascular salvage of a chronically thrombosed hemodialysis arteriovenous fistula2024 · 1 citations
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  3. 3“Wire kissing technique” and “externalization and pull-through technique” for treating chronic total occlusion in hemodialysis vascular access: A case report2024
  4. 4Transhepatic venous access as a vessel-preserving salvage strategy for temporary hemodialysis in venous access exhaustion2026
  5. 5Percutaneous interventional thrombectomy of an endovascular AV-fistula, a case report2024