Prosthetic axillary-axillary arteriovenous straight access (necklace graft) for difficult hemodialysis patients: A prospective single-center experience

The reasonable patency and minimal complications associated with these bypasses show that they are a valid option for complex patients. We advocate the use of this bypass in patients with exhaustion of all access possibilities in both arms with a patent superior vena cava, subclavian, and brachiocephalic veins. We also indicate it in case of unilateral central venous stenosis or obstruction with complete exhaustion of all other access possibilities on the contralateral side.