Improved arterio–arterial grafts as a novel approach for hemodialysis in poor access patients: A case report

Arterio-arterial grafts (AAG) represent a specialized type of vascular access. However, AAG is associated with a high incidence of thrombotic occlusion, which prompted us to improve this surgical approach. The improved technique involves creating a low-flow autologous arteriovenous fistula (AVF) at the distal end of the AAG, termed improved AAG (IAAG). We report a case of a 65-year-old female patient with recurrent thrombosis of her AAG, who underwent creation of a low-flow autologous arteriovenous fistula (AVF) at the distal end of the AAG. The patient was followed up for 15 months postoperatively, and the intervention frequency was significantly lower than that before the operation. This case demonstrates that the IAAG surgical technique can prolong the patency of AAG.