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Navigation of a Dormant AV Fistula for PCI in a Patient With High-Risk NSTEMI

Kevin A Friede1,2, Zachary K Wegermann1,2,3, Sunil V Rao2,3

  • 1Division of Cardiology, Duke University, Durham, North Carolina.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

Transradial access for coronary angiography can be achieved even with an arteriovenous fistula in end-stage renal disease patients. This case demonstrates successful navigation through a dormant AV fistula for percutaneous coronary intervention, preserving vascular access options.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Interventional Cardiology

Background:

  • End-stage renal disease (ESRD) patients often require hemodialysis via arteriovenous (AV) fistulae.
  • AV fistulae typically preclude ipsilateral transradial access (TRA) for coronary angiography due to potential complications.
  • Limited vascular access in ESRD patients presents a significant clinical challenge.

Keywords:
AV, arteriovenousBAT, balloon-assisted trackingCICU, cardiac intensive care unitESRD, end-stage renal diseaseLAD, left anterior descending coronary arteryNSTEMI, non-ST-segment elevation myocardial infarctionPAD, peripheral artery diseasePCI, percutaneous coronary interventionTRA, transradial accesscoronary angiographypercutaneous coronary interventionperipheral vascular disease

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