The construction of arteriovenous fistula for hemodialysis in patients with chronic obstructive arterial disease in the upper limb.

Objective: Describe the construction of arteriovenous fistula for hemodialysis in chronic renal patient on hemodialysis who presented chronic arterial obstruction in the upper limb.

Methods: A surgical procedure was performed on a patient with obstruction of the brachial artery in its proximal third. The procedure was carried out by the construction of a bypass with autologous vein between the proximal brachial and distal brachial arteries and the performing of an arteriovenous fistula with superficialized and anteriorized basilic vein, with anastomosis in the bypass at the same surgical procedure.

Results: There was good immediate result and arteriovenous fistula presented function for 43 months.

Conclusions: Even when faced with chronic obstructive arterial disease in the arm, there is the possibility of creating a new arteriovenous fistula for hemodialysis.