HeRO Graft Placement for Hemodialysis Patient with Bilateral Central Venous Occlusion: A Case Report

Central venous occlusion in hemodialysis patients may cause venous hypertension and access failure, and some cases are refractory to endovascular therapy.We report a 55-year-old man with bilateral central venous occlusion who developed progressive swelling of the left arm and face.Multiple angioplasty attempts failed, and a Hemodialysis Reliable Outflow (HeRO) graft was created in the right arm, with the venous outflow component positioned at the cavoatrial junction.After successful dialysis and subsequent ligation of the left arteriovenous fistula, the swelling completely resolved.This case highlights HeRO grafts as a salvage option.