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Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
Published on: April 1, 2022
Minimally Invasive Treatment of Tunneled Central Venous Catheter-Associated Venobronchial Fistula
Manisha Koneru1, Johanna Lou2, Dana McCloskey2
1Medical School, Cooper Medical School of Rowan University, Camden, New Jersey.
Abstract:
Venobronchial fistula (VBF) is a rare complication of central venous access. We describe a 30-year-old woman with VBF associated with a tunneled venous catheter. She presented with a drowning sensation associated with infusions. Extravasation of contrast material on fluoroscopy confirmed the presence of a fistula between the superior vena cava and bronchial tree. After multidisciplinary planning, the patient underwent catheter removal. An interventional pulmonologist placed a bronchial blocker and a cardiac surgeon positioned an endovascular occlusion balloon to mitigate life-threatening risk of intrabronchial hemorrhage. This highlights the importance of a multidisciplinary team to manage risks associated with catheter removal in patients with VBF.
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