Venous ulceration of the hand secondary to a cimino fistula.
Cimino fistula is an anastomosis created for chronic hemodialysis, between the radial artery and cephalic vein near the wrist. Its complications include thrombosis (most frequent), infection, congestive heart failure, arterial insufficiency, venous hypertension, vascular access neuropathy, and aneurysms. Of these, venous hypertension appears to occur rarely. We report here a case where it resulted in pigmentation, swelling, and ulceration of the middle finger. It was surgically treated, without ligating the arteriovenous fistula, by selective ligation of tributaries from the affected fingers.
Deshmukh
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Section of Vascular Surgery, Guthrie Medical Center/Guthrie Clinic, Sayre, PA 18840.
Reppert
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M
D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D006801:Humans; D008297:Male; D006435:Renal Dialysis; D014689:Venous Insufficiency / Q000209:etiology*