A Case Report: Pulmonary Embolism (PE) in Hemodialysis Patients with Autogenous Arteriovenous Fistula (AVF) Occlusion during Ultrasonography

Abstract

Backgrounds: Symptomatic pulmonary embolism is rare and fatal. We report a case of a patient with fatal pulmonary embolism during ultrasonography examination of autogenous arteriovenous fistula. Case presentation: We present the case of a 53-year-old woman with end-stage renal disease (ESRD). The left forearm arteriovenous fistula is the vascular access. After had maintenance hemodialysis for about 9 years, the patient developed an aneurysm behind the anastomosis. She visited the doctor after finding that the arteriovenous fistula tremor disappeared. During the ultrasound examination, the patient lost consciousness. Pulmonary embolism was confirmed by enhanced CT. The patient was improved after tracheal intubation and active anticoagulation therapy. The follow-up angiography showed arteriovenous fistula anastomotic stenosis, autologous arteriovenous reconstruction surgery was performed. Conclusions: Symptomatic and fatal pulmonary embolism was rarely during ultrasonography examination of autogenous arteriovenous fistula. Therefore, clinicians should pay attention to this possibility to provide timely and appropriate treatment.