Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 3 2018 03 06 208 209 EN Sadegh Asadi Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran. Mahmood Hosseinzadeh Maleki Department of Cardiovascular Surgery, Birjand Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran. Bibi Fatemeh Shakhs Emampour Department of Anesthesiology, Birjand Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran. Morteza Hajihosseini Birjand CardioVascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran. Majid Jafarnejad Birjand Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran. 2016 11 27 2017 04 16 Vascular access for dialysis is essential for these patients with end-stage renal disease, improvements in hemodialysis managment have lead to extended life expectancy. The creation and maintenance of hemoaccess occupies a significant portion of most vascular and general surgery practices.Venous hypertension due to arteriovenous fistula is usually secondary to venous outlet obstruction. Side to side proximal artery arteriovenous fistula serves as a certain cause of hemodialysis, but it is rarely reported as a peripheral venous hypertension cause. We are reporting a case with developed venous hypertension having dermal injuries in the arm. The patient underwent successful side-to-side radio cephalic fistula creation in the snuffbox a year ago. https://acta.tums.ac.ir/index.php/acta/article/view/6028 https://acta.tums.ac.ir/index.php/acta/article/download/6028/5070