Radial Arteriovenous Fistula following Percutaneous Coronary Intervention

Dutton, J. Walter; McClellan, W. Thomas

doi:10.1097/prs.0000000000000481

Cited by 2 publications

(4 citation statements)

References 3 publications

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“…Some local indicators for puncture site complications may include hematoma, arterial spasm, excessive bleeding, or swelling. Despite the rarity of AV fistulas following transradial access sites, the growing popularity of coronary interventions may contribute to an increase in their occurrence, emphasizing the importance of proper diagnosis and early intervention [4]. Other potential procedural complications include radial artery occlusion, non-occlusive radial artery injury, radial artery pseudoaneurysm, and radial artery spasm [2].…”

Section: Discussionmentioning

confidence: 99%

Radial Arteriovenous Fistula After a Left Heart Catheterization: Two Case Reports

Okam¹,

Ibe²,

Stein³

et al. 2023

Cureus

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The distal transradial artery (TRA) approach has been increasing in popularity over recent years due to its favorable ergonomics and potential for fewer vascular complications. Other advantages include lower bleeding risk, early ambulation, lower procedural costs, and same-day discharge, resulting in additional cost savings. We discuss two cases of patients who underwent left heart catheterizations through the radial artery access site and afterwards experienced fistula formation. Our case series brings to light a rare occurrence of arteriovenous fistulas (AVFs) following cardiac catheterization via the transradial artery site, thus enhancing our knowledge of the risk associated with this access site. The pathophysiology of AV fistula remains the same regardless of transfemoral or transradial artery use. During the procedure, needle diversion into the venous tributary results in an unrecognized combined artery and vein puncture, which usually seals spontaneously. However, if the communication persists, an AV fistula may occur. The majority of patients who suffer from an iatrogenic AVF as a result of TRA do not develop clinical signs of hemodynamic significance. There are various therapeutic strategies, which include surgical repair, placement of a covered stent, ultrasound-guided compression of the AV fistula, and conservative management. Both of our patients were evaluated by vascular surgery; one of the patients found the constant pulsation and bruit burdensome and underwent surgical repair.

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Section: Discussionmentioning

confidence: 99%

Radial Arteriovenous Fistula After a Left Heart Catheterization: Two Case Reports

Okam¹,

Ibe²,

Stein³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…Nevertheless, Multiple sequelae encountered with TRA such as radial artery occlusion, hematomas, pseudoaneurysm and AVF, although less frequent, do occur [ 7 ]. The characteristics of previous radial AVF cases relative to catheter-based procedures have been reviewed [ 1 , 3 , 5 , 8 – 21 ]. The clinical manifestations of AVFs are mainly related to venous dilation as the arterial blood bypasses the tissues and capillaries, returning directly to veins [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Most fistulas, mainly because they were easy to identify, were frequently treated with ligation. However, when the fistula tissue was mixed and difficult to distinguish, or the radial artery was severely damaged and even hemodynamics was affected, further repair of the artery was required [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

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Radial arteriovenous fistula complicated with ischemic steal syndrome after transradial cardiac catheterization: a case report and literature review

2022

BMC Surg

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Background The radial arteriovenous fistula (AVF) is a rare complication occurring after transradial cardiac catheterization. Patients with AVF typically present with signs of venous dilation, such as swelling or palpable thrills. However, neurological complications secondary to radial AVFs are rare. This paper reported a rare case of ischemic steal syndrome that occurred 11 months after the transradial cardiac catheterization, most likely as a consequence of radial arteriovenous fistula. Case presentation This paper described a case of a 73-year-old female, who complained of right forearm swelling and radial 1–3 fingers numbness for several months after the catheterized stent surgery through radial approach. Upon Clinical examination, this patient presented with a slight bump and palpable thrill at the distal third of right forearm, and the sensory of radial 1–3 fingers and pinch force was compromised. The Ultrasonography and computed tomography angiography (CTA) of the upper extremity revealed AVF between the right radial artery and the adjacent vein. Microsurgery was performed successfully to ligate the fistula and reconstruct the radial artery. The numbness has gradually improved about 1 week after the surgery, with no recurred swelling. The two-point pinch force and digital sensitivity recovered at the 20-month follow-up. What’s more, due to the scarcity of cases, the optimal therapy for iatrogenic radial AVF is controversial. Accordingly, we provided a literature review of previous reports of catheter-related radial AVFs and proposed an algorithm to manage them. Conclusions We believe that once an AVF is diagnosed, early treatment options such as compression or surgery are necessary to relieve symptoms and prevent further complications. Otherwise, serious complications can occur, including the ischemic steal syndrome.

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Radial Arteriovenous Fistula following Percutaneous Coronary Intervention

Cited by 2 publications

References 3 publications

Radial Arteriovenous Fistula After a Left Heart Catheterization: Two Case Reports

Radial Arteriovenous Fistula After a Left Heart Catheterization: Two Case Reports

Radial arteriovenous fistula complicated with ischemic steal syndrome after transradial cardiac catheterization: a case report and literature review

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