Patient has a non-maturing AVG. there is significant tortuosity of the cephalic vein, as well as a branch point. Both the main cephalic vein and the accessory cephalic vein were tortuous; the main cephalic was also small and atretic higher in the upper arm.

The doctor resected a significantly kinked portion of vein and performed end-to-end anastomosis, AFTER the anastomosis was finished, an angiogram was done in order to determine which branch of the cephalic vein was more suitable for dialysis (see findings above), and to choose which tributary to ligate. tributary was ligated, wound was closed.