BRACHIO-JUGULAR SHUNTING PROVIDES PERMANENT VASCULAR ACCESS IN OCCLUSION OF SUBCLAVIAN VEINS

A significant progress is achieved in treatment of patients with end-stage chronic renal disease. Program hemodialysis is the leading and widely available method for treatment of such patients. Long-term hemodialysis requires an adequate permanent vascular access. The most reliable vascular access for hemodialysis is the native arteriovenous fistula. But with periodically occurring restenosis and thromboses of the reconstruction zone a need arises in use of different variants of access for hemodialysis using both autologous material and synthetic grafts. In the article a clinical example of brachio-jugular shunting is given as a variant of permanent vascular access in patients with occlusion of subclavian veins. The given example shows that the surgery of vascular access is a creative process requiring individual approach to each patient and that it is necessary to consider all available arterial and venous pools suitable for formation of arteriovenous fistula.