Wang Kang-Ling, Li Szu-Yuan, Chuang Chiao-Lin, Chen Tzen-Wen, Chen Jinn-Yang
Department of Medicine, Division of Nephrology, Taipei Veterans General Hospital; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Am J Kidney Dis. 2006 Dec;48(6):990-2. doi: 10.1053/j.ajkd.2006.08.020.
Vascular access-associated compartment syndrome is reported rarely in hemodialysis patients. A 62-year-old female hemodialysis patient experienced left-arm compartment syndrome caused by a nontransposed brachiobasilic arteriovenous fistula. A subfascial hematoma that developed because of perforation of the posterior wall of the basilic vein was not detected by Doppler ultrasound initially, and subsequent heparinized hemodialysis caused progression of the hematoma. Neuromuscular sequelae were prevented by performing an emergent fasciotomy, and transposition of the arterialized basilic vein was performed later to prevent similar complications in the future. This case report shows the risk for the occurrence of such a devastating complication if the nontransposed brachiobasilic fistula is used for hemodialysis vascular access.
