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Fig. 2A. —54-year-old woman with radiocephalic access at left forearm in place less than 2 months. Retrograde catheterization failed to canalize obliterated outflow vein. Venogram via puncture of distal radial artery (A, arrowhead) shows obliterated segment (A and B, arrow) of outflow vein. Perforation with contrast medium extravasation (B, arrowhead) in small side branch during wire canalization was noted. Perforation disappeared spontaneously after main outflow vein was opened. AVA = arteriovenous anastomosis; RA = radial artery.