In a 70-year-old hypotensive hemodialysis patient, a tunnel catheter with CUFF in the jugular vein failed to work and both cephalic veins were too thin to be used, and an anastomosis between the guillotine vein and the ulnar artery was proposed. The ulnar artery was found to be too thin by incision, so the guillotine vein was separated for more than 10 cm and anastomosed with the radial artery through a curved subcutaneous tunnel, which was successful.