There is described a case of a hemodialysed (HD) patient using buttonhole (BH) technique, with self-cannulation for about one year. The patient presents bactereamia with starting point in “false channels”, pulmonary and muscular septic metastases. The complications associated with buttonhole technique in our case, are not so frequently reported and required a long hospitalization and careful care.

Cannulation of the arteriovenous fistula (AVF) in the today's population is more difficult and challenging than ever. The frequency of cannulation-related complications was significantly lower with the BH technique compared with the rope-ladder method, but infections-related should not be underestimated. More attention should be attributed to patients with self-cannulation to avoid the “false channels”.