Femoral arteriovenous fistula: a complication of temporary hemodialysis catheter placement

Abstract

The femoral vein is increasingly being used as a temporary route for dual-lumen hemodialysis catheter placement because it is thought to be safer than the internal jugular or subclavian vein sites. However, several factors preclude the wider use of indwelling femoral catheters for hemodialysis, including interference with ambulation and concern over bleeding, infection, and deep thrombosis. Herein we describe a case of right superficial femoral arteriovenous fistula as a complication of the insertion of a dual-lumen hemodialysis catheter into the right femoral vein. The arteriovenous fistula was successfully managed with surgical vascular repair. From this experience, we emphasize that it is important for physicians and nursing staff treating patients with indwelling central catheters to exercise vigilance to allow early detection and treatment of these potentially serious, albeit rare, complications.

Femoral Arteriovenous Fistula Associated With Leg Swelling 6 Months After Removal of a Hemodialysis Catheter

“…1 Moreover, the use of a fine-gauge needle to locate the vein before introduction of the guide wire using the Seldinger needle is suggested as well. 12 …”

“…AVF as a complication of dual-lumen HD catheter insertion has been described in the medical literature. Kuramochi et al 12 described a case of right superficial femoral AVF with a symptom of arterial bleeding. Chiba et al 13 reported a case of an AVF associated with calf pain 2 months after the removal of the catheter.…”

“…Chiba et al 13 reported a case of an AVF associated with calf pain 2 months after the removal of the catheter. According to the literature, 12 – 16 the most common initial symptoms were swelling, hemorrhage, limb pain, hematoma, thromboembolism, and cardiac failure. Limb swelling along with calf pain as the initial symptom was rare in any of the cases.…”

Indirect Complication of AV Graft Thrombectomy-Thrombolysis Secondary to Previously Attempted Placement of a Temporary Hemodialysis Catheter

“…This site is often favored by many because it carries no risk for pneumothorax, falsely obviating the need for image guidance. 3 This likely accounts for its frequent use in placing temporary dialysis catheters. However, as is often the case, a lack of imaging guidance and anatomical understanding of the relationship between the femoral artery and its bifurcation vessels relative to the femoral vein may lead to a low access within the upper thigh, resulting in traumatic injury of the superficial femoral artery as in this case.…”

Emergency Femoral Hemodialysis Catheter Placement Complicated by Prevesical Hematoma

“…According to the study by El Minshawy et al, common complications are infections (40%), thrombosis (7.5%), bleeding from a punctured femoral artery (5%), and groin hematoma (0.5%) (2). Other rare complications that have been described in case reports include pulmonary thromboembolism, femoral arteriovenous fistula, retroperitoneal hematoma, and psoas muscle abscess (3)(4)(5)(6). In this report, we describe the case of femoral vein perforation with prevesical hematoma after inserting a temporary hemodialysis catheter.…”