Du Tao, Zheng Xing
The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, China.
Medicine (Baltimore). 2025 Jan 17;104(3):e41281. doi: 10.1097/MD.0000000000041281.
Temporary central venous catheters are commonly used for patients who require emergency hemodialysis. In rare instances, this procedure can result in a very serious complication known as arteriovenous fistula (AVF). Although some cases of femoral arteriovenous fistula have been reported previously in the literature; however, the incidence of iliac AVF precipitated by a hemodialysis catheter is exceedingly uncommon. The purpose of this study is to report a case in which a hemodialysis catheter caused a femoral arteriovenous fistula and to describe the successful treatment, thereby providing a reference for the diagnosis and treatment of such conditions in the future.
Herein, we report the case of a patient with diabetes and end-stage kidney disease (ESKD) who presented with an iliac arteriovenous fistula as a complication of hemodialysis catheter insertion into the right femoral vein. Two years after hemodialysis catheter removal, the patient was admitted to our institution with swelling of the right lower limb and calf pain.
The patient was subsequently diagnosed with an iliac arteriovenous fistula by computed tomography angiography and angiography.
The patient was transferred to the Vascular Surgery Department for surgical treatment.
The patient's leg swelling improved after surgery. After 1 year of follow-up, there was no occurrence of swelling in the patient's right leg.
If the patient has a history of femoral venous catheter placement and develops limb swelling, in addition to considering the presence of a femoral arteriovenous fistula, it is important to consider the possibility of an iliac AVF. Iliac AVF are rare disorders. The primary goal for treatment of IAVF is to relieve associated symptoms. Based on the results of this study, the endovascular approach is safe and effective for the treatment of iliac AVF. Iliac AVFs are rare disorders. The primary goal of treatment for iliac AVFs is to relieve associated symptoms. Based on the results of this study, the endovascular approach is safe and effective in the treatment of iliac AVFs.
临时中心静脉导管常用于需要紧急血液透析的患者。在极少数情况下，该操作可能导致一种非常严重的并发症，即动静脉瘘（AVF）。虽然先前文献中已有一些股动静脉瘘的病例报道；然而，由血液透析导管引发的髂动静脉瘘的发生率极为罕见。本研究的目的是报告一例血液透析导管导致股动静脉瘘的病例，并描述成功的治疗方法，从而为今后此类病症的诊断和治疗提供参考。
在此，我们报告一例患有糖尿病和终末期肾病（ESKD）的患者，其因右侧股静脉插入血液透析导管而出现髂动静脉瘘这一并发症。血液透析导管拔除两年后，该患者因右下肢肿胀和小腿疼痛入住我院。
随后通过计算机断层血管造影和血管造影，该患者被诊断为髂动静脉瘘。
患者被转至血管外科进行手术治疗。
术后患者腿部肿胀有所改善。随访1年后，患者右腿未再出现肿胀。
如果患者有股静脉置管史且出现肢体肿胀，除了考虑股动静脉瘘的存在外，重要的是要考虑髂动静脉瘘的可能性。髂动静脉瘘是罕见疾病。治疗髂动静脉瘘的主要目标是缓解相关症状。基于本研究结果，血管内治疗方法对于治疗髂动静脉瘘是安全有效的。髂动静脉瘘是罕见疾病。治疗髂动静脉瘘的主要目标是缓解相关症状。基于本研究结果，血管内治疗方法在治疗髂动静脉瘘方面是安全有效的。
