Through-and-through Technique for Occluded and Ruptured Graft-vein Anastomosis: A Case Report

An 88-year-old woman with end-stage renal disease presented with early re-occlusion of her left arm brachioaxillary arteriovenous graft (AVG).During the procedure, graft-vein (GV) anastomosis was found occluded and ruptured, making it impossible for the guidewire to pass through the outflow vein in an antegrade fashion.However, a transjugular approach allowed the guidewire to pass through the GV anastomosis in a retrograde fashion.Using a through-and-through technique, stent grafts were successfully installed into the GV anastomosis site.After a 2-month follow-up with ultrasound and fluoroscopy, it was found that the graft function was well-preserved.