# Percutaneous Arteriovenous Fistula Creation in a Patient With Recurrent Vascular Access Failures Due to Thrombophilia: A Case Report

## TL;DR

A 62-year-old man with a blood clotting disorder successfully had a new type of vascular access created for hemodialysis after repeated failures.

## Contribution

The use of a novel endovascular system to create a functional arteriovenous fistula in a high-risk patient.

## Key findings

- The patient was diagnosed with antiphospholipid syndrome due to repeated clotting at dialysis access sites.
- A new arteriovenous fistula using an endovascular system matured successfully and allowed hemodialysis.
- The central venous catheter was removed after two months following successful fistula maturation.

## Abstract

We present the case of a 62-year-old man who, after experiencing two episodes of thrombosis at the vascular access site for hemodialysis, was diagnosed with antiphospholipid syndrome based on the positivity of lupus anticoagulant on two separate occasions. After initiating anticoagulation therapy, a new arteriovenous fistula was created; however, it encountered another episode of thrombosis. As a result, it was decided to establish a new arteriovenous fistula using a novel endovascular system. Two months after its creation, the fistula met the criteria for physiological maturation, allowing the first hemodialysis session and the removal of the central venous catheter after two months of use.