Salvage of a radiocephalic fistula by the palmar arch

We present a child with mild problems during haemodialysis due to stenosis of the proximal radial artery of his radiocephalic fistula. However, his problems spontaneously subsided. Follow-up sonography revealed arterial occlusion proximal to the fistula with retrograde flow in the distal segment. Kt/V and shunt flow were normal. Physical examination confirmed proximal radial artery occlusion with collateral blood supply via the palmar arch. There were no signs of steal. To our knowledge this is the first description of a patient experiencing adequate haemodialysis with arterial occlusion proximal to a radiocephalic fistula salvaged by collateral arterial supply via the palmar arch.