Radial arteriovenous fistula complicated with ischemic steal syndrome after transradial cardiac catheterization: a case report and literature review.
Arteriovenous fistula
Cardiac catheterization
Case report
Ischemic steal syndrome
Treatment
Journal
BMC surgery
ISSN: 1471-2482
Titre abrégé: BMC Surg
Pays: England
ID NLM: 100968567
Informations de publication
Date de publication:
21 Mar 2022
21 Mar 2022
Historique:
received:
08
12
2021
accepted:
15
03
2022
entrez:
22
3
2022
pubmed:
23
3
2022
medline:
24
3
2022
Statut:
epublish
Résumé
The radial arteriovenous fistula (AVF) is a rare complication occurring after transradial cardiac catheterization. Patients with AVF typically present with signs of venous dilation, such as swelling or palpable thrills. However, neurological complications secondary to radial AVFs are rare. This paper reported a rare case of ischemic steal syndrome that occurred 11 months after the transradial cardiac catheterization, most likely as a consequence of radial arteriovenous fistula. This paper described a case of a 73-year-old female, who complained of right forearm swelling and radial 1-3 fingers numbness for several months after the catheterized stent surgery through radial approach. Upon Clinical examination, this patient presented with a slight bump and palpable thrill at the distal third of right forearm, and the sensory of radial 1-3 fingers and pinch force was compromised. The Ultrasonography and computed tomography angiography (CTA) of the upper extremity revealed AVF between the right radial artery and the adjacent vein. Microsurgery was performed successfully to ligate the fistula and reconstruct the radial artery. The numbness has gradually improved about 1 week after the surgery, with no recurred swelling. The two-point pinch force and digital sensitivity recovered at the 20-month follow-up. What's more, due to the scarcity of cases, the optimal therapy for iatrogenic radial AVF is controversial. Accordingly, we provided a literature review of previous reports of catheter-related radial AVFs and proposed an algorithm to manage them. We believe that once an AVF is diagnosed, early treatment options such as compression or surgery are necessary to relieve symptoms and prevent further complications. Otherwise, serious complications can occur, including the ischemic steal syndrome.
Sections du résumé
BACKGROUND
BACKGROUND
The radial arteriovenous fistula (AVF) is a rare complication occurring after transradial cardiac catheterization. Patients with AVF typically present with signs of venous dilation, such as swelling or palpable thrills. However, neurological complications secondary to radial AVFs are rare. This paper reported a rare case of ischemic steal syndrome that occurred 11 months after the transradial cardiac catheterization, most likely as a consequence of radial arteriovenous fistula.
CASE PRESENTATION
METHODS
This paper described a case of a 73-year-old female, who complained of right forearm swelling and radial 1-3 fingers numbness for several months after the catheterized stent surgery through radial approach. Upon Clinical examination, this patient presented with a slight bump and palpable thrill at the distal third of right forearm, and the sensory of radial 1-3 fingers and pinch force was compromised. The Ultrasonography and computed tomography angiography (CTA) of the upper extremity revealed AVF between the right radial artery and the adjacent vein. Microsurgery was performed successfully to ligate the fistula and reconstruct the radial artery. The numbness has gradually improved about 1 week after the surgery, with no recurred swelling. The two-point pinch force and digital sensitivity recovered at the 20-month follow-up. What's more, due to the scarcity of cases, the optimal therapy for iatrogenic radial AVF is controversial. Accordingly, we provided a literature review of previous reports of catheter-related radial AVFs and proposed an algorithm to manage them.
CONCLUSIONS
CONCLUSIONS
We believe that once an AVF is diagnosed, early treatment options such as compression or surgery are necessary to relieve symptoms and prevent further complications. Otherwise, serious complications can occur, including the ischemic steal syndrome.
Identifiants
pubmed: 35313862
doi: 10.1186/s12893-022-01562-7
pii: 10.1186/s12893-022-01562-7
pmc: PMC8939090
doi:
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
106Informations de copyright
© 2022. The Author(s).
Références
Korean J Thorac Cardiovasc Surg. 2012 Dec;45(6):421-3
pubmed: 23275929
Heart. 2019 May;105(9):668-670
pubmed: 30700521
J Interv Cardiol. 2015 Jun;28(3):305-12
pubmed: 25989895
Plast Reconstr Surg. 2014 Sep;134(3):495e-497e
pubmed: 25158739
World J Radiol. 2014 Sep 28;6(9):677-92
pubmed: 25276311
J Card Surg. 2017 Dec;32(12):805-806
pubmed: 29235152
Isr Med Assoc J. 2013 Jun;15(6):313-4
pubmed: 23882900
Tex Heart Inst J. 2021 Jun 11;48(2):
pubmed: 34116568
J Vasc Access. 2021 Sep;22(5):795-800
pubmed: 32779515
J Cardiovasc Med (Hagerstown). 2012 Jan;13(1):50-2
pubmed: 21532499
J Cardiol Cases. 2015 Sep 26;12(6):192-194
pubmed: 30546593
Catheter Cardiovasc Interv. 2021 Feb 1;97(2):278-281
pubmed: 32034860
Curr Cardiol Rev. 2021;17(3):279-293
pubmed: 32814536
Can J Cardiol. 2009 Jun;25(6):e206
pubmed: 19536393
JACC Cardiovasc Interv. 2014 Sep;7(9):e123-4
pubmed: 25234687
Vasc Med. 2009 Nov;14(4):371-6
pubmed: 19808723
Circulation. 2005 Feb 15;111(6):e99
pubmed: 15710772
J Med Case Rep. 2013 Jan 14;7:21
pubmed: 23316970
Jpn J Radiol. 2013 Jul;31(7):505-10
pubmed: 23609100
Heart Lung. 2012 Mar-Apr;41(2):203-6
pubmed: 21831437
J Vasc Bras. 2019 Jan 30;18:e20180086
pubmed: 31191628
Korean Circ J. 2010 Dec;40(12):677-9
pubmed: 21267392
Clin Res Cardiol. 2016 Sep;105(9):797-9
pubmed: 27103619
Indian Heart J. 2008 Jan-Feb;60(1):64
pubmed: 19212027