{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:16:29Z","timestamp":1790882189137,"version":"4.1.0"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Central venous occlusion is a recognised complication of haemodialysis vascular access that can render ipsilateral arteriovenous fistulas dysfunctional. When endovascular options have been exhausted, extra-anatomical vein-to-vein bypass offers a surgical strategy for access preservation. This study evaluated long-term patency outcomes, bypass thrombosis natural history and baseline predictors of primary patency loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review was performed of all patients undergoing extra-anatomical venous bypass to the external iliac vein (EIV) for central venous occlusion at a tertiary vascular centre between 2016 and 2025. Kaplan\u2013Meier analysis estimated primary, assisted-primary and secondary patency and freedom from bypass graft thrombosis. Cox proportional hazards regression using baseline variables identified predictors of primary patency loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Forty-six patients were included; median follow-up was 75.4\u2009months. Primary patency was 76.1%, 45.7% and 19.6% at 1, 2 and 5\u2009years. Assisted-primary patency was 91.1%, 79.7% and 43.7% at the same time points. Secondary patency was 98.0%, 92.9% and 90.4% at 1, 2 and 5\u2009years. Reintervention for AVF or graft-vein anastomotic stenosis was required in 39 patients (84.8%). Bypass graft thrombosis occurred in 23 patients (50.0%); all underwent thrombectomy, of which 16 (69.6%) were salvaged. Graft infection occurred in four patients (8.7%), all requiring explantation. Six patients (13.0%) required fistula ligation for recurrent cannulation site bleeding. Total permanent access loss occurred in 17 patients (37.0%). On multivariable Cox regression, longer dialysis vintage (adjusted HR 0.87 per year, 95% CI 0.77\u20130.97,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.016) was independently associated with reduced primary patency loss. Pre-operative access flow did not predict outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Extra-anatomical venous bypass provides durable long-term access preservation for haemodialysis patients with central venous occlusion refractory to endovascular intervention. Although primary patency declines over time and reintervention burden is expected, secondary patency remains above 90% at 5\u2009years in carefully selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298261488905","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:45:06Z","timestamp":1790747106000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term outcomes of extra-anatomical venous bypass for central venous occlusion in haemodialysis patients: A single-centre experience"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1451-7468","authenticated-orcid":false,"given":"Karthigesu","family":"Aimanan","sequence":"first","affiliation":[{"name":"Vascular Surgery Unit, Department of Surgery, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Aizat","family":"Tamlikha","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, Department of Surgery, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3188-0325","authenticated-orcid":false,"given":"Michael","family":"Arvind","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, Department of Surgery, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Putera","family":"Mas Pian","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, Department of Surgery, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanif","family":"Hussein","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, Department of Surgery, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1742152"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvsvf.2023.05.009"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.07010618"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0005202021"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.12.001"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.12.046"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.5334\/jbsr.1991"},{"issue":"1","key":"e_1_3_3_9_2","first-page":"3","article-title":"Extra-anatomical veno-venous surgical bypass for central vein occlusion in patients with ipsilateral arterio-venous fistula for haemodialysis \u2013 a single centre experience","volume":"72","author":"Saravana KS","year":"2017","unstructured":"Saravana KS, Zainal AA. Extra-anatomical veno-venous surgical bypass for central vein occlusion in patients with ipsilateral arterio-venous fistula for haemodialysis \u2013 a single centre experience. Med J Malaysia 2017; 72(1): 3\u20136.","journal-title":"Med J Malaysia"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.12.042"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298251414687"},{"issue":"2","key":"e_1_3_3_12_2","first-page":"165","article-title":"Predictors for failure to mature of autogenous arteriovenous fistulae: Alor Setar experience","volume":"67","author":"Najmi W","year":"2012","unstructured":"Najmi W, Tong LH, Nallusamy M, et al. Predictors for failure to mature of autogenous arteriovenous fistulae: Alor Setar experience. Med J Malaysia 2012; 67(2): 165\u2013168.","journal-title":"Med J Malaysia"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2007.11.001"},{"issue":"6","key":"e_1_3_3_14_2","article-title":"Venous bypass using the internal jugular vein as the outflow tract for treating central venous stenosis and cephalic arch stenosis in hemodialysis access","volume":"13","author":"Wang M","year":"2025","unstructured":"Wang M, Lu P, Li Q, et al. Venous bypass using the internal jugular vein as the outflow tract for treating central venous stenosis and cephalic arch stenosis in hemodialysis access. J Vasc Surg Venous Lymphat Disord 2025; 13(6): 102280.","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.2174\/011874303X400804250923060404"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.02.033"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261488905","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298261488905","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261488905","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:47:28Z","timestamp":1790880448000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298261488905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":15,"alternative-id":["10.1177\/11297298261488905"],"URL":"https:\/\/doi.org\/10.1177\/11297298261488905","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"article-number":"11297298261488905"}}