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[Arteriovenous fistula complicating central venous catheterization]
J Kautzner1, J Krivánek, J Horák
1II. interní katedra I. lékarské fakulty Univerzity Karlovy, Praha.
Casopis Lekaru Ceskych
|July 13, 1990
Summary
Iatrogenic arteriovenous fistulae are rare but serious complications following central venous catheterization. This case highlights a delayed diagnosis of a subclavian catheter-induced fistula leading to cardiac insufficiency.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Nephrology
Background:
- Central venous catheterization is a common procedure in patients with chronic renal failure.
- Iatrogenic arteriovenous fistulae are infrequent but significant complications of central venous catheterization.
- Delayed diagnosis can lead to severe hemodynamic sequelae.
Observation:
- A 57-year-old patient with chronic renal failure developed a continuous murmur in the right subclavicular area 19 months post-central venous catheter insertion.
- The patient presented with increasing signs of left-sided cardiac insufficiency.
- Digital subtraction angiography revealed an arteriovenous fistula between the internal thoracic artery and the right brachiocephalic vein.
Findings:
- The case demonstrates a rare delayed complication of subclavian central venous catheterization.
- The fistula formation resulted in significant hemodynamic alterations.
- The findings underscore the importance of considering vascular complications after central venous access.
Implications:
- This case emphasizes the need for vigilance regarding rare complications of central venous catheterization.
- Early recognition and diagnosis of iatrogenic arteriovenous fistulae are crucial for preventing adverse cardiac events.
- Further research into preventative strategies and diagnostic methods for these rare fistulae is warranted.