Limits...
Coil emboliztion of a dialysis fistula

Fong AF - MedPix (2006)

View Article: MedPix Image - MedPix Case

Affiliation: Madigan Army Medical Center

ABSTRACT

Diagnosis: Coil emboliztion of a dialysis fistula

History: The patient is a 71 year old female who originally had radial-cephalic hemodialysis fistula created in the left upper arm, ipsilateral to a cardiac pacemaker. The pacemaker caused a central venous stenosis, which, in conjunction with arterialized flow through the fistula, caused massive left arm swelling. The patient had placement of a right forearm fistula, and at the same setting had surgical ligation of the problematic left arm fistula. On follow-up visit, She had persistent left arm swelling and a palpable thrill in the ligated left arm fistula. She was referred for coil embolization of the fistula in an effort to spare her another operation.

Findings: Preoperative fistulogram showed brisk flow through the hemodialysis fistula. Following coil placement, fistulogram showed more sluggish flow through the fistula. It is not unusual for an embolized vessel to have persistent flow initially, as the coils may not caused thromosis immediately.

Ddx: 1. Unsuccessful ligation of the dialysis fistula - proven with fistulogram.

Dxhow: Fistulogram and coil embolization.

Exam: Left arm edema and palpable thrill over the AV fistula.

No MeSH data available.


Venogram shows a central stenosis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=MPX1076&req=5

MPX1076_synpic29539: Venogram shows a central stenosis


Coil emboliztion of a dialysis fistula

Fong AF - MedPix (2006)

Venogram shows a central stenosis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1076&req=5

MPX1076_synpic29539: Venogram shows a central stenosis

View Article: MedPix Image - MedPix Case

Affiliation: Madigan Army Medical Center

ABSTRACT

Diagnosis: Coil emboliztion of a dialysis fistula

History: The patient is a 71 year old female who originally had radial-cephalic hemodialysis fistula created in the left upper arm, ipsilateral to a cardiac pacemaker. The pacemaker caused a central venous stenosis, which, in conjunction with arterialized flow through the fistula, caused massive left arm swelling. The patient had placement of a right forearm fistula, and at the same setting had surgical ligation of the problematic left arm fistula. On follow-up visit, She had persistent left arm swelling and a palpable thrill in the ligated left arm fistula. She was referred for coil embolization of the fistula in an effort to spare her another operation.

Findings: Preoperative fistulogram showed brisk flow through the hemodialysis fistula. Following coil placement, fistulogram showed more sluggish flow through the fistula. It is not unusual for an embolized vessel to have persistent flow initially, as the coils may not caused thromosis immediately.

Ddx: 1. Unsuccessful ligation of the dialysis fistula - proven with fistulogram.

Dxhow: Fistulogram and coil embolization.

Exam: Left arm edema and palpable thrill over the AV fistula.

No MeSH data available.