J Korean Soc Radiol.  2017 Dec;77(6):382-387. 10.3348/jksr.2017.77.6.382.

Successful Hemodialysis Using an Iatrogenic Graft-to-Vein Fistula in Failing Arteriovenous Graft with Chronic Thrombotic Occlusion

• Kang YR
• Kwon JH

• KMID: 2396496
• DOI: http://doi.org/10.3348/jksr.2017.77.6.382

Abstract

An iatrogenic graft-to-vein fistula that develops between a vascular access graft and an adjacent vein is a rare but significant complication. We report a case of an arteriovenous hemodialysis graft (AVG) with an iatrogenic graft-to-vein fistula and a thrombosed venous limb. The AVG was preserved and used for hemodialysis through the fistula and the cephalic vein. The thrombus in the venous limb could not be removed.

MeSH Terms

Extremities
Fistula*
Renal Dialysis*
Thrombosis
Transplants*
Veins

Figure

• 

  Fig. 1. Fistulography in a 77-year-old male with end-stage renal disease. A. Fistulography via the arterial limb of graft shows a fistula (black arrow) between the arterial limb of the graft (white arrowheads) and an adja-cent native cephalic vein (black arrowheads) of left upper arm. Contrast material (empty arrow) leaked and spread out around the cephalic vein through the cannulation site of venous limb of the graft. B. Fistulography via the native cephalic vein shows diffuse stenosis in cephalic vein (black arrowheads) and collateral veins (empty arrows). C. Fistulography via the arterial limb of the graft (white arrowhead) after balloon angioplasty of the cephalic vein stenosis shows residual steno-sis in the cephalic vein (black arrowhead) and graft-to-vein fistula (black arrow) with some residual collateral veins (empty arrows). Basilic vein (curved arrow) is visualized by communication with the antecubital vein draining into the cephalic vein. D. Fistulography after balloon dilatation of cephalic vein revealed the disappearance of the stenosis in the cephalic vein (black arrowheads) and markedly decreased collateral vessels. Basilic vein (empty arrow) is visualized by communication with the antecubital vein draining into the ce-phalic vein. E. Doppler study of the arteriovenous hemodialysis graft after the procedure shows a graft-to-vein fistula between arterial limb of the graft and native cephalic vein (arrow). G = arterial limb of the graft, V = cephalic vein

Reference

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