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Iatrogenic radial arteriovenous fistula closure via intraluminal compression in a patient with fibromuscular dysplasia
Journal article   Open access   Peer reviewed

Iatrogenic radial arteriovenous fistula closure via intraluminal compression in a patient with fibromuscular dysplasia

Evan M. Luther, Eric Huang, Hunter King and Eric Peterson
BMJ case reports, v 15(3), 248085
03 Mar 2022
DOI: https://doi.org/10.1136/bcr-2021-248085
PMID: 35241449
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8895944View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Science & Technology
Fibromuscular dysplasia (FMD) is an arteriopathy of medium-sized vessels causing pathological arterial wall fragility. However, only minimal data exist on evaluating the risk of transradial access (TRA) in these patients. We describe the case of a woman in her 70s who underwent left middle meningeal artery embolisation for an acute-on-chronic subdural haematoma via right TRA. Radial angiography demonstrated significant FMD throughout the entire right upper extremity. To prevent radial spasm, a 23 cm sheath was placed without difficulty. However, follow-up angiography demonstrated the presence of a new radial arteriovenous fistula (AVF) just distal to the brachial bifurcation. Since no forearm haematoma or limb ischaemia developed, the procedure was continued transradially. After embolisation, the guide catheter was removed and follow-up angiography demonstrated resolution of the fistula. This case illustrates that, in the absence of concerning clinical signs, compression from the guide catheter alone may facilitate thrombosis of an acutely identified iatrogenic radial AVF.

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Collaboration types
Domestic collaboration
Web of Science research areas
Surgery
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