Rezziki Abdellah, Abuatayef Taha, Benzirar Adnane, Elmahi Omar
Introduction: Vascular access for hemodialysis of choice remains the Arteriovenous Fistulas (AVF) of the Upper Limb, the creation of Lower Limb (LL) arteriovenous fistula is an alternative to the depletion of vascular access sites to the upper limb. The most used surgical technique is the transposition of the femoral vein; recent and poorly known technique. Material and methods: Through two clinical observations, we report our experience in the creation of exotic vascular approaches (AVF-LL). Discussion: The complete exhaustion of the veins of both upper limbs and the presence of venous disease occlusive central veins is a major problem in the creation of FAV upper limb, the most commonly used alternative to the lower limb is the transposition of the femoral vein described for the first time in 2000 by Jackson. Conclusion: The depletion of vascular sites is a delicate problem, hence the interest of knowing how to use the tertiary vascular approaches, particularly fistulas of the lower limb.