Stent graft repair of iatrogenic femoral arteriovenous fistula with acute bleeding after hemodialysis catheter insertion

Abstract

An arteriovenous fistula (AVF) is an abnormal connection between an artery and a vein. Double-lumen catheters are widely used for gaining temporary access in patients requiring acute hemodialysis (HD). Several complications are associated with the insertion of these catheters, including bleeding, infection, arterial injuries, and deep venous thrombosis. An iatrogenic AVF is a rare and severe complication following catheterization for temporary HD. Here, we report the case of a patient who developed an iatrogenic AVF following catheterization for acute HD resulting in acute bleeding. A 61-year-old male experienced acute renal failure with pulmonary edema. A 12 French (Fr) dialysis catheter was inserted into the right femoral vein for emergent HD. Active pulsation bleeding was observed around the catheter at the right inguinal area after first HD. A thrill was felt at the superficial femoral artery after the repair of its anterior side. Angiography revealed iatrogenic AVF, which was successfully treated with stent graft repair.