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| Title: | Blood flow of dialysis arteriovenous graft compromised by a brachial artery-brachial vein fistula |
| Authors: | Yeh, TS;Meng, SW;Linz, L;Wu, CC |
| Contributors: | Institute of Cellular and Systems Medicine |
| Abstract: | INTRODUCTION: Thrombosis of a dialysis arteriovenous graft (AVG) usually occurs because of obstruction at the graft-venous junction or outflow veins. 1,2 This case report presents an unusual cause of AVG thrombosis involving competing flow from a brachial artery-brachial vein (B-B) fistula. CASE DESCRIPTION: An 82-year-old woman was referred for endovascular thrombectomy of the dialysis AVG. The patient had a history of diabetes, coronary artery disease, peripheral arterial occlusive disease, and paroxysmal atrial fibrillation under therapy with clopidogrel and apixaban. The patient began undergoing hemodialysis from May 2019, initially via a central vein catheter at the left internal jugular vein. A 7-mm loop polytetrafluoroethylene AVG was created in Jan, 2020. The patient began to use the AVG for hemodialysis on May 9, 2020. After dialysis via the AVG twice, thrombosis developed without any preceding physical or hemodynamic abnormalities. Endovascular thrombectomy was performed to salvage vascular access. Before the procedure, 5000 units of heparin was administered. A 7F short sheath was placed in the arterial limb of the graft, and clots in the venous limb were fragmented with a 7-mm 4-mm angioplasty balloon (Wanda, Boston Scientific, Boston, MA, USA) and aspirated from the sheath as much as possible. Another 7F short sheath was placed in the venous limb of the graft. After passing the guidewire through the brachial artery, the arterial plug was flattened with balloon dilatation, and clots were aspirated from the sheath. On performing angiogram of the outflow veins from the arterial sheath, the flow observed was slow. The outflow vein was wired smoothly with the free advancement of the inflated angioplasty balloon to the central veins. |
| Date: | 2022-03 |
| Relation: | Acta Cardiologica Sinica. 2022 Mar;38(2):214-216. |
| Link to: | http://dx.doi.org/10.6515/ACS.202203_38(2).20210914A |
| JIF/Ranking 2023: | http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1011-6842&DestApp=IC2JCR |
| Cited Times(WOS): | https://www.webofscience.com/wos/woscc/full-record/WOS:000766265300013 |
| Cited Times(Scopus): | https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85125669094 |
| Appears in Collections: | [吳志成] 期刊論文
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| ISI000766265300013.pdf | | 524Kb | Adobe PDF | 138 | View/Open |
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