A Rare Case of Radial Arteriovenous Fistula After Coronary Angiography

Abstract

The percutaneous transfemoral approach has been routinely used for cardiac catheterization and coronary angioplasty. Local vascular complications following angioplasty are seen in 5% to 10% of patients, especially in those who need prolonged anticoagulation. Transradial access for coronary procedures dramatically reduces access site complications. We report a rare case of radial arteriovenous fistula, which developed after coronary angiography perfomed using the transradial approach.

Distal arteriovenous fistula formation after percutaneous coronary intervention: An old complication of a new access site

“…Several factors including advanced age and arterial hypertension predispose patients to iatrogenic AVFs 13,14 . Furthermore, high intraprocedural heparin dosing is associated with delayed healing of the access sites of punctured arteries 13 . In the case reported here, the development of an AV fistula is most likely related to the radial artery and cephalic vein or its branches being punctured simultaneously at the time of arterial access.…”

“…An iatrogenic AVF results in a disruption of the normal blood flow pattern by allowing arterial blood to directly return to the heart, bypassing and potentially compromising capillary flow. Several factors including advanced age and arterial hypertension predispose patients to iatrogenic AVFs 13,14 . Furthermore, high intraprocedural heparin dosing is associated with delayed healing of the access sites of punctured arteries 13 .…”

Unusual Vascular Complications Associated with Transradial Coronary Procedures Among 10,324 Patients: Case Based Experience and Treatment Options

“…Iatrogenic AVF may occur as a complication of transradial catheterizations, however, the incidence is exceedingly low and the only available data is from case reports . Even though the operators have enough experience regarding the treatment modalities of iatrogenic femoral AVF such as surgical repair, covered stents and ultrasound guided compression, the optimal therapy for iatrogenic radial AVF is even controversial.…”

Arteriovenous Fistula as a Rare Early Complication of Transradial Coronary Angiography: With Literature Review on Management Strategies

“…Earlier case reports on radial AV fistula have all utilized the use of surgical ligation, with a range of presentation from 2 months post-angiography up to 1 year [1,2,4,6,8,9] (Table 1). Out of the four AV fistula cases from Tatli et al, only one case required surgical ligation [1].…”