Percutaneous Creation of Jump Bypass in a Native Arteriovenous Hemodialysis Fistula

This chapter describes the experience with percutaneous creation of jump bypass grafts in nonmature and failed arteriovenous hemodialysis fistulas based on a case series of 10 patients. Percutaneous intervention has been used to salvage nonmature fistulas, dysfunctional fistulas, and grafts. Frequently, venous outflow stenosis is the major cause of arteriovenous fistula and graft failure. Long-segment stenoses and chronically occluded venous outflow stenoses are more difficult to treat percutaneously and may require surgical revision. This chapter describes an endovascular technique creating a percutaneous jump bypass from the cephalic vein to the basilic vein using stent grafts in all patients with excellent immediate results. Limited available follow-up is also reported, including patency of two stent grafts for more than 2 years.