Retroesophageal internal jugular-to-internal jugular vein bypass for venous occlusion in a patient with complex hemodialysis access.

This report describes a right-hand dominant, self-dialyzing patient whose left brachiocephalic autogenous access was previously rescued for left brachiocephalic vein thrombosis with a bypass to the right internal jugular vein (IJV). After 1 year, the left IJV thrombosed, resulting in painful edema and venous dilatation. A retroesophageal IJV-IJV bypass was created, preserving the left brachiocephalic autogenous access.