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degois.publication.titlePortuguese Journal of Nephrology and Hypertensionpt_PT
dc.contributor.authorCastro, A.-
dc.contributor.authorAlmeida, P.-
dc.contributor.authorSilva, F.-
dc.contributor.authorRego, D.-
dc.contributor.authorTavares, J.-
dc.contributor.authorSantos, J.-
dc.contributor.authorSilva, F.-
dc.contributor.authorQueirós, J.-
dc.contributor.authorCabrita, A.-
dc.contributor.authorAlmeida, R.-
dc.identifier.citationPort J Nephrol Hypert 2018; 32(3): 299-304pt_PT
dc.description.abstractIntroduction: Vascular access (VA) for hemodialysis (HD) is the lifeline for End Stage Renal Disease (ESRD) patients. Long-term HD patients often have exhaustion of their venous patrimony for an autologous VA construction and, sometimes, even for a central venous catheter (CVC) placement. Case report: We describe the case of a 43-year-old woman with ESRD due to lupus nephritis, on maintenance HD since 2009. She also had secondary antiphospholipid syndrome and was chronically anticoagulated. Nevertheless, the patient had multiorgan thrombotic events (without sequelae) and several episodes of irreversible thrombosis of arteriovenous fistulas. Her HD course was also marked by multiple severe CVC infections, at diferente locations; a hemoperitoneum during cholecystectomy, and an immediate thrombosis of the renal artery of a kidney transplant. She was admitted to our hospital after an irreversible dysfunction of a right jugular CVC, with documentation of thrombosis of the superior and inferior vena cava. Exhaustion of the venous patrimony for HD was assumed and it was decided to make an arterio-arterial graft (AAG) of early cannulation. The first cannulation of the AAG was performed two days after surgical intervention, with no complications. The patient performed a twelve hour per week HD treatment with good efficiency. Conclusion: AAG is an alternative for HD patients who have exhausted all their venous patrimony and it can be considered prior to the placement of a CVC as their sole remaining vascular access.pt_PT
dc.publisherSociedade Portuguesa de Nefrologiapt_PT
dc.subjectarterio-arterial graftpt_PT
dc.subjectearly cannulation graftpt_PT
dc.subjectautologous vascular accesspt_PT
dc.titleArterio-arterial graft – an option for hemodialysis patients with exhaustion of venous patrimonypt_PT
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