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

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.