Salvage of hemodialysis access in infected arteriovenous fistulas

• Infection combined with additional complications of arteriovenous fistulas is a serious threat to access in patients with upper-extremity polytef (polytetrafluoroethylene) grafts. We present three cases of infected access grafts that were treated with systemic antibiotics, excision of the grafts, and primary anastomosis of the arterialized vein to artery for access salvage. The new arteriovenous fistulas were used immediately, preventing interruptions in hemodialysis regimens. This technique of immediate reconstruction allows the surgeon to utilize the arterialized outflow vein and save other sites of access for future use. ( Arch Surg . 1991;126:1303-1305)