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NDT Plus Advance Access published online on August 8, 2008
NDT Plus, doi:10.1093/ndtplus/sfn129
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Salvage of a radiocephalic fistula by the palmar arch

Noël Knops1 and Erik Beek2

1 Department of Pediatric Nephrology, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 80590, 3508 CA Utrecht, The Netherlands
2 Department of Pediatric Radiology, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 80590, 3508 CA Utrecht, The Netherlands

Correspondence: Noël Knops, Department of Pediatric Nephrology, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 80590, 3508 CA Utrecht, The Netherlands. Tel: +31-88-7554554; Fax: +31-88-7555349; E-mail: N.B.B.Knops{at}umcutrecht.nl


  Abstract

We present a child with mild problems during haemodialysis due to stenosis of the proximal radial artery of his radiocephalic fistula. However, his problems spontaneously subsided. Follow-up sonography revealed arterial occlusion proximal to the fistula with retrograde flow in the distal segment. Kt/V and shunt flow were normal. Physical examination confirmed proximal radial artery occlusion with collateral blood supply via the palmar arch. There were no signs of steal. To our knowledge this is the first description of a patient experiencing adequate haemodialysis with arterial occlusion proximal to a radiocephalic fistula salvaged by collateral arterial supply via the palmar arch.

Key Words: palmar arch • radiocephalic fistula • steal

Received for publication July 15, 2008. Accepted for publication July 17, 2008.


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