{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:10:39Z","timestamp":1777936239611,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T00:00:00Z","timestamp":1713830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2025,5]]},"abstract":"\n Background:<\/jats:title>\n A 48-year-old patient presented 4\u2009months after insertion of a right sided Haemodialysis with Reliable Outflow (HeRO\u00ae, Merit Medical) graft with a discharging abscess at the site of the brachial artery anastomosis. There was localised involvement of the arterial Gore\u00ae Acuseal inflow graft that necessitated its removal. The venous outflow component was thought salvageable as infection was well localised to the region of the antecubital fossa.<\/jats:p>\n <\/jats:sec>\n \n Objectives:<\/jats:title>\n Alternative access options were limited so we sought to preserve the venous outflow portion of the patient\u2019s original graft \u2013 minimising tissue damage and avoiding the need for a dialysis line.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n The infected arterial graft was excised, leaving behind the original SuperHero\n \u00ae<\/jats:sup>\n connector and venous graft. A left sided tunnelled axillary necklace technique was utilised to restore arterial inflow.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n After a four-day recovery, the patient went on to successfully resume their usual haemodialysis regimen without any complications. Convalescent imaging, repeat blood cultures, and monitoring of inflammatory markers showed no signs of residual infection at 6\u2009weeks.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The originality of this case was the way in which an axillary necklace inflow graft was connected to the pre-existing venous outflow portion of the HeRO\u00ae haemodialysis graft system, allowing the excision of the infected inflow graft at the brachial anastomosis. This technique could be viewed as an effective salvage procedure as it allowed the venous outflow portion of the original graft to remain in situ, minimised tissue damage and enabled the patient to swiftly resume haemodialysis without the need for a line.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/11297298241235866","type":"journal-article","created":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T23:16:33Z","timestamp":1713914193000},"page":"995-999","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Axillary necklace graft salvage of a locally infected Haemodialysis with Reliable Outflow (HeRO\u00ae) graft"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1587-0689","authenticated-orcid":false,"given":"Adam","family":"Lloyd","sequence":"first","affiliation":[{"name":"Norfolk and Norwich Vascular Unit, Norfolk and Norwich University Hospital, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7240-5638","authenticated-orcid":false,"given":"Philip C","family":"Bennett","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich Vascular Unit, Norfolk and Norwich University Hospital, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip W","family":"Stather","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich Vascular Unit, Norfolk and Norwich University Hospital, Norwich, UK"},{"name":"Norwich Medical School, University of East Anglia, Norwich Research Park, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,4,23]]},"reference":[{"issue":"9","key":"e_1_3_2_2_2","first-page":"197","article-title":"Invasive methicillin-resistant Staphylococcus aureus infections among dialysis patients\u2013United States, 2005","volume":"56","author":"Centers for Disease Control and Prevention (CDC)","year":"2007","unstructured":"Centers for Disease Control and Prevention (CDC). Invasive methicillin-resistant Staphylococcus aureus infections among dialysis patients\u2013United States, 2005. MMWR Morb Mortal Wkly Rep 2007; 56(9): 197\u2013199.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.7150\/ijms.6710"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit546"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2012.08.445"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.02.001"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002480-200011000-00032"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semvascsurg.2003.11.004"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s100169910090"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2006.09.028"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02139410"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10016-004-0139-x"},{"issue":"1","key":"e_1_3_2_13_2","first-page":"64","article-title":"Necklace fistula for complicated dialysis access patients","volume":"9","author":"Sirlak M","year":"2009","unstructured":"Sirlak M, Eryilmaz S, Cakici M, et al. Necklace fistula for complicated dialysis access patients. Anadolu Kardiyol Derg 2009; 9(1): 64\u201365.","journal-title":"Anadolu Kardiyol Derg"},{"issue":"4","key":"e_1_3_2_14_2","first-page":"186","article-title":"Necklace graft for difficult haemodialysis access: two case reports from Saudi Arabia","volume":"7","author":"Khalid B","year":"2018","unstructured":"Khalid B, Rafeef A, Assil A. Necklace graft for difficult haemodialysis access: two case reports from Saudi Arabia. Int J Pharm Res All Sci 2018; 7(4): 186\u2013189.","journal-title":"Int J Pharm Res All Sci"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.06.064"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211012205"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(96)70202-1"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2017.06.024"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298241235866","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298241235866","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298241235866","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:24:19Z","timestamp":1777692259000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298241235866"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,23]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1177\/11297298241235866"],"URL":"https:\/\/doi.org\/10.1177\/11297298241235866","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,23]]}}}