{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:17:29Z","timestamp":1778156249227,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T00:00:00Z","timestamp":1765065600000},"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":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Brachial artery transposition (BAT) is a valuable tertiary vascular access (VA) option for hemodialysis (HD) patients at high risk of prosthetic graft\/catheter infection. The primary limitation of BAT, however, is its dependence on a superficial vein for blood return, which frequently fails due to repeated cannulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 74-year-old female HD patient with a history of recurrent AVG infections presented with severe difficulty continuing dialysis due to the occlusion and thrombosis of her BAT\u2019s return vein. Conventional VA options, including a new AVG or a cuffed catheter, were deemed high-risk due to her history of infection, and basilic vein transposition (BVT) was excluded due to the small caliber of the basilic vein.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Technique:<\/jats:title>\n                    <jats:p>To salvage the patient\u2019s native access, we performed a novel surgical procedure: the fistulization of the BAT to the adjacent deep brachial vein via an end-to-side anastomosis. This successfully converted the single-site arterial access into a functional brachio-brachial arteriovenous fistula (AVF). Post-conversion, the access was utilized for two-site cannulation entirely within the BAT segment (arterial withdrawal and venous return), effectively establishing an arterial-arterial cannulation approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The postoperative course was uneventful. The access was cannulated 1\u2009day after surgery, demonstrating an access flow volume of 650\u2009mL\/min at 7-day follow-up. Venous pressure was stably maintained, confirming effective flow and minimal recirculation. The patient successfully maintained HD with adequate efficiency using the novel access for 2\u2009years until her death, with no VA-related complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Fistulization of the BAT to the deep vein successfully salvaged HD access in a severely challenged patient by overcoming return vein failure. This technique overturns the convention that the venous return needle must be placed in a vein, offering a valuable, autogenous option for specific patients with exhausted VA reserves and a high risk of graft infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298251398762","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T04:56:12Z","timestamp":1765169772000},"page":"1364-1367","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Fistulization of brachial artery transposition to a deep vein: Overcoming return vein failure in a severely access-challenged hemodialysis patient"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4251-5315","authenticated-orcid":false,"given":"Kotaro","family":"Suemitsu","sequence":"first","affiliation":[{"name":"Osaka Keisatsu Hospital, Amagasaki, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoko","family":"Suemitsu","sequence":"additional","affiliation":[{"name":"Kinki Central Hospital, Itami, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,7]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.02.001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.09.004"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.10.043"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012070643"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.11.093"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2021.01.038"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/112972980700800409"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2021.09.025"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.07.057"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2020.05.020"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298251398762","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298251398762","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298251398762","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:00:57Z","timestamp":1778155257000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298251398762"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,7]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/11297298251398762"],"URL":"https:\/\/doi.org\/10.1177\/11297298251398762","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,7]]}}}