Unusual Fistula Development in Cannulation Zone of Arteriovenous Prosthetic Graft: A Case Report

Abstract

An iatrogenic graft-to-vein fistula is a rare complication with uncertain clinical significance that can occur due to repetitive needle injury traversing between a vascular access graft and a nearby vein. We present a case of an arteriovenous graft (AVG) complicated by an iatrogenic graft-to-vein fistula at the proximal cannulation zone and a thrombosed distal venous limb caused by a steno-occlusive lesion at the graft-vein (GV) anastomosis. Aspiration thrombectomy and percutaneous transluminal angioplasty (PTA) was insufficient to address the high-flow iatrogenic graft-to-vein fistula. Consequently, a vascular covered stent was used to salvage the AVG for hemodialysis for approximately 280 days.