Abstract
IntroductionIatrogenic arteriovenous fistula is a vascular condition that may result from coronary angiography. Many case reports have described arteriovenous fistula occurrence after coronary angiography using the transfemoral access route, but rarely as a complication of using the transradial approach. We report a rare case of a patient with arteriovenous fistula following transradial artery coronary angiography.Case presentationA 62-year-old Caucasian man underwent emergent coronary angiography using the right radial artery approach. One month after angiography, he discovered a turbulent sound near the access site. A right radial arteriovenous fistula was found upon duplex ultrasound investigation. The patient was treated conservatively. At 1-year follow-up, the arteriovenous fistula was unchanged and the patient remained hemodynamically stable and asymptomatic.ConclusionIatrogenic arteriovenous fistula is a rare vascular complication of transradial artery coronary angiography. The natural history of arteriovenous fistula is benign and is thought to resolve spontaneously; therefore, a conservative approach, as opposed to surgical ligation, is recommended as the first-line treatment.
Highlights
Iatrogenic arteriovenous fistula is a vascular condition that may result from coronary angiography
Two to five percent of patients presenting with an acute coronary syndrome (ACS) experience major bleeding [1,2], a clinical factor which has been established as an independent predictor of mortality [3,4]
As a substantial portion of bleeding occurs at the femoral site during transfemoral coronary angiography and/or angioplasty, the field of interventional cardiology has turned its attention to accessing the heart from the radial artery
Summary
Iatrogenic AVF is a rare vascular complication of transradial coronary angiography that may be treated conservatively without any interventions. It was enough of an oddity to motivate me to go to our family doctor He prescribed a nitroglycerin spray and blood work that I had done at a local lab. The following day, my cardiologist carried out an angioplasty procedure and inserted two stents. I soon noticed what I called “my vibrating wrist” in my right wrist, in the area that the angioplasty catheter had been inserted. The surgeon recommended that no further action be taken since risks of the status quo were likely less than if I were to have vascular surgery to try to correct the fistula. Author details 1Prairie Vascular Research Network; Department of Cardiology, University of Saskatchewan, 2574 Linner Way, Regina, SK S4V 1K3, Canada.
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