Iatrogenic arteriovenous fistula after revascularization of the hand.
This is the first report of an iatrogenic arteriovenous fistula complicating revascularization of an incomplete amputation of the hand, due to inadvertent anastomosis of the proximal radial artery to the distal cephalic vein. This resulted in a severely painful, massively swollen hand, which was initially diagnosed as an infection or poor venous outflow and eventually required a below-elbow amputation. This complication of replantation or revascularization should be preventable by carefully matching the thickness of the vessel wall and the diameter of the lumen, to avoid anastomosing a proximal artery to a distal vein.
Jones
Neil F
NF
Department of Orthopaedic Surgery and Division of Plastic and Reconstructive Surgery, UCLA Hand Center, University of California-Los Angeles, 200 UCLA Medical Plaza, Los Angeles, CA 90095, USA.
Brown
Erin E
EE
Khiabani
Kayvan T
KT
D000328:Adult; D000671:Amputation, Surgical; D000673:Amputation, Traumatic / Q000601:surgery*; D000714:Anastomosis, Surgical; D001164:Arteriovenous Fistula / Q000209:etiology*; D005543:Forearm Injuries / Q000601:surgery*; D006225:Hand / Q000098:blood supply*; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D019300:Medical Errors; D017534:Radial Artery / Q000601:surgery