Abstract
BACKGROUND: Arterio-venous (AV) fistula is created for patients requiring renal replacement therapy (hemodialysis and hemofiltration). A failing A-V fistula requires urgent treatment to keep it patent. Understanding the simple tips and tricks will contribute to the quality of life for the patient with end-stage renal disease and reducing radiation dose to the operator. CASE SUMMARY: A 77 year old male with end-stage renal disease, hypertension and coronary artery disease. He has been on regular haemodialysis after A-V fistula (left forearm) was constructed in 2013. He presented with 2 weeks history of A-V fistula occlusion. Examination was essentially normal. Serum sodium=136mmol/l, potassium=5.5mmol/l urea=100mg/l, creatinine=3.5mg/dl. The Doppler scan showed 50 % stenosis just proximal to the anastomosis with calcification. Percutenous arteriography and venography was done with non-compliance balloon (3x12mm) up to 24 atm . The post procedure venography showed restoration of flow across the fistula. CONCLUSION: Endovascular treatment of a failing A-V fistula can be life saving. The simple tips and tricks of using the groin route, reducing the concentration of contrast and maneuver devices may contribute to safety and reduce radiation to the operator.
Highlights
CASE SUMMARY: A 77 year old male with end-stage renal disease, hypertension and coronary artery disease. He has been on regular haemodialysis after A-V fistula was constructed in 2013
He presented with 2 weeks history of A-V fistula occlusion
Percutenous arteriography and venography was done with non-compliance balloon (3x12mm) up to 24 atm
Summary
Arteriovenous fistulas are the preferred route for hemodialysis access in patients with end-stage renal disease. These surgically constructed fistulas, usually between the radial artery and the cephalic vein. A stenosis in any part of the circuit (arterial inflow or venous outflow) can limit forward flow. When these mechanisms are favorable, the vein dilates and produces a usable fistula. CASE SUMMARY: A 77 year old male with end-stage renal disease, hypertension and coronary artery disease. He has been on regular haemodialysis after A-V fistula (left forearm) was constructed in 2013. The post procedure venography showed restoration of flow across the fistula
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Clinical Cardiology and Cardiovascular Interventions
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
