Sustained Hemodialysis Through Thoracic Collateral Veins After Exhaustion of Conventional Vascular Access: A Case Report from a Sub-Saharan African Country

We present the case of a 59-year-old man, on hemodialysis for 16 years, diagnosed with central venous stenosis confirmed by angiotomography and associated failure of conventional vascular access. Five years ago, the puncture of collateral veins in the chest wall was initiated as an alternative venous access for dialysis treatment. Since then, the patient has maintained satisfactory dialysis adequacy (spKt/V ≥ 1.2), demonstrating that unconventional vascular access can ensure therapeutic continuity, clinical stability, and effective long-term dialysis management.