Swelling of the hand after arteriovenous fistula for hemodialysis

Despite a high patency rate and low incidence of infections, several complications have been described with the Brescia subcutaneous arteriovenous fistula. We recently observed five patients with swelling of the hand and wrist secondary to increased distal vein flow. Ligation of the distal vein, with or without proximal reconstruction resulted in cure. Proximal vein patency must be assessed.