Akademik Veri Yönetim Sistemi
Case Reports in vascular Medicine, cilt.4135532, sa.1155, ss.1-4, 2022 (Hakemli Dergi)
Background. Ankle arteriovenous fistulas are the rarest vascular access type among lower extremity fistulas for hemodialysis
patients with end-stage renal disease. Here, we present a case of a tibial-saphenousfistula that remained open for a long time
despite a recurrent anastomotic aneurysm. Case Presentation. A 43-year-old female patient who had been undergoing
hemodialysis via a right femoral tunnel catheter for six months was referred for recurrent catheter infection and a 4 cm
pulsatile mass in the anterior aspect of the ankle. While she had been undergoing hemodialysis through a right tibial-saphenous fistula for fourteen years, hemodialysis continued after the fistula’s closure due to total occlusion of the great
saphenous vein through the tunneled catheter. After balloon angioplasty to the right subclavian vein, we performed right upper
extremity basilic vein transposition. Later, after starting adequate dialysis from the basilic vein fistula and removing the
femoral catheter, we performed a resection of the anastomotic aneurysm in the right ankle and repaired the anterior tibial
artery. Because this is the only ambulatory patient and the one with the longest patency of ankle arteriovenous fistulas in the
literature and the only case in which the anterior tibial artery was used, the case is presented and discussed in light of the
literature. Conclusion. Despite many complications and low patency rates reported in the literature, ankle vessels should be
considered for autogenous vascular access in selected patients.