Endovascular embolization of arteriovenous fistula in a patient with hand ischemia

Fominykh N.M.

Department of transplantology, nephrology and artificial organs, Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia

Zulkarnaev A.B.

Department of transplantology, nephrology and artificial organs, Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia

Gegenava B.B.

GU "Moskovskiĭ oblastnoĭ nauchno-issledovatel'skiĭ klinicheskiĭ institut im. M.F. Vladimirskogo"

Kardanakhishvili Z.B.

Department of transplantology, nephrology and artificial organs, Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia

Endovascular embolization of arteriovenous fistula in a patient with hand ischemia

Authors:

Fominykh N.M., Zulkarnaev A.B., Gegenava B.B., Kardanakhishvili Z.B.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2019;(6): 111‑116

DOI: 10.17116/hirurgia2019061111

Downloaded: 51

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Fominykh NM, Zulkarnaev AB, Gegenava BB, Kardanakhishvili ZB. Endovascular embolization of arteriovenous fistula in a patient with hand ischemia. Pirogov Russian Journal of Surgery. 2019;(6):111‑116. (In Russ.)
https://doi.org/10.17116/hirurgia2019061111

Подписка 2025 (Pirogov Russian Journal of Surgery)

Close metadata

Recommended articles:

Surgical treatment of traumatic arteriovenous fistulas of extremities. Pirogov Russian Journal of Surgery. 2024;(7):92-102

We present a case report of atypical hand ischemia probably caused by a combination of venous insufficiency and steal syndrome in patient with arteriovenous fistula for hemodialysis. Unclear clinical symptoms may be due to severe trophic disorders (delayed treatment) or combination of two complications (steal syndrome and venous insufficiency). At the same time, we did not get any diagnostic data confirming organic injury of the upper limb veins or central veins. AVF closure did not result positive changes. Angiography made it possible to assess veins patency, to detect additional patent AVF and to close it. It was previously assumed that this previously created AVF was completely occluded. Therefore, positive changes were observed: rapid healing of trophic ulcers, complete disappearance of pain and gradual restoration of function.

Keywords:

arteriovenous fistula

steal syndrome

hand ischemia

venous insufficiency

vascular access

endovascular embolization

Authors:

Fominykh N.M.

Department of transplantology, nephrology and artificial organs, Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia

Zulkarnaev A.B.

Department of transplantology, nephrology and artificial organs, Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia

Gegenava B.B.

GU "Moskovskiĭ oblastnoĭ nauchno-issledovatel'skiĭ klinicheskiĭ institut im. M.F. Vladimirskogo"

Kardanakhishvili Z.B.

Department of transplantology, nephrology and artificial organs, Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia

List of references:

Arhuidese IJ, Obeid T, Hicks C, Qazi U, Botchey I, Zarkowsky DS, Reifsnyder T, Malas MB. Vascular access modifies the protective effect of obesity on survival in hemodialysis patients. Surgery. 2015;158(6):1628-1634. https://doi.org/10.1016/j.surg.2015.04.036
Malas MB, Canner JK, Hicks CW, Arhuidese IJ, Zarkowsky DS, Qazi U, Schneider EB, Black JH 3rd, Segev DL, Freischlag JA3. Trends in incident hemodialysis access and mortality. JAMA Surg. 2015;150(5):441-448. https://doi.org/10.1001/jamasurg.2014.3484
Zhang JC, Al-Jaishi AA, Na Y, de Sa E, Moist LM. Association between vascular access type and patient mortality among elderly patients on hemodialysis in Canada. Hemodial Int. 2014;18(3):616-624. https://doi.org/10.1111/hdi.12151
Vaes RH, Tordoir JH, Scheltinga MR. Blood flow dynamics in patients with hemodialysis access-induced hand ischemia. J Vasc Surg. 2013;58(2):446-451.e1. https://doi.org/10.1016/j.jvs.2013.01.032
Fokou M, Teyang A, Ashuntantang G, Kaze F, Eyenga VC, Chichom Mefire A, Angwafo F 3rd. Complications of arteriovenous fistula for hemodialysis: an 8-year study. Ann Vasc Surg. 2012;26(5):680-684. https://doi.org/10.1016/j.avsg.2011.09.014
Huber TS, Larive B, Imrey PB, Radeva MK, Kaufman JM, Kraiss LW, Farber AM, Berceli SA; HFM Study Group. Access-related hand ischemia and the Hemodialysis Fistula Maturation Study. J Vasc Surg. 2016;64(4):1050-1058.e1. https://doi.org/10.1016/j.jvs.2016.03.449
Modabber M, Kundu S. Central venous disease in hemodialysis patients: an update. Cardiovasc Intervent Radiol. 2013;36(4):898-903. https://doi.org/10.1007/s00270-012-0498-6
Garin YuYu, Asadulaev ShM, Sukhov VK, Ryasnyanskiy VYu. Central vein stenosis in patients on chronic hemodialysis, from etiology to treatment (literature review). Nefrologiya i dializ. 2016;18(1):35-39. (In Russ.)
Neville RF, Abularrage CJ, White PW, Sidawy AN. Venous hypertension associated with arteriovenous hemodialysis access. Semin Vasc Surg. 2004;17(1):50-56.
Shi Y, Zhu M, Cheng J, Zhang J, Ni Z. Venous stenosis in chronic dialysis patients with a well-functioning arteriovenous fistula. Vascular. 2016;24(1):25-30. https://doi.org/10.1177/1708538115575649
Horita Y. Percutaneous transluminal angioplasty for central venous stenosis or occlusion in hemodialysis patients. J Vasc Access. 2018. https://doi.org/10.1177/1129729817747545
Hall HC, Moudgill N, Kahn M, Burkhart R, Eisenberg J, Rao A, DiMuzio P. An unusual cause of venous hypertension after dialysis access creation. Ann Vasc Surg. 2011;25(7):983.e1-e4. https://doi.org/10.1016/j.avsg.2011.02.035
Lobov GI, Gurkov AS. Microcirculatory blood flow in the hand in patients with end-renal failure on hemodialysis: dependence on the shunt blood flow in arteriovenous fistula. Sovremennye problemy nauki i obrazovaniya. 2014;6:988. (In Russ.)
Alferov SV, Karpov SA, Grinev KM, Vasilyev AN. Permanent vascular access for hemodialysis: a modern view. Nefrologiya. 2013;17(6):56-70. (In Russ.)

Close metadata