Peripheral venous hypertension of the hand: a complication of a proximal radial artery arteriovenous fistula.
Venous hypertension due to dialysis access is usually secondary to outflow obstruction. The bidirectional proximal radial artery arteriovenous fistula (PRAVF) has been proposed as a procedure to increase autogenous fistula utilization and is rarely reported to cause peripheral venous hypertension. We report here a case of peripheral venous hypertension from a PRAVF, the first report to our knowledge caused by a peripheral outflow obstruction. A proximal occlusion in the medial cephalic vein led to retrograde flow through the median antebrachial vein into the hand. We briefly discuss this complication and considerations of its management in relation to the bidirectional PRAVF creation.
Anaya-Ayala
J E
JE
Division of Vascular Surgery, The Methodist DeBakey Heart and Vascular Center, The Methodist Hospital, Houston, Texas 77030, USA.
Charlton-Ouw
K M
KM
Cardon
A L
AL
Peden
E K
EK
D000328:Adult; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D016121:Brachiocephalic Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D006225:Hand / Q000098:blood supply*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000628:therapy; D008026:Ligation; D008297:Male; D010690:Phlebography; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D014647:Varicose Ulcer / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D014689:Venous Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery