An interesting case: retrograde blood flow from a LIMA sustaining hemodialysis via an AVF.
A case is described in which the inflow of a left radiocephalic arteriovenous fistula was being maintained by retrograde flow from a patent left internal mammary artery bypass graft, distal to a severe left subclavian artery stenosis. The clinical manifestations of this phenomenon were angina, lateral chest wall pain during dialysis, and distal hypoperfusion of the left hand. After stenting of the subclavian lesion, all symptoms resolved.
Schoenkerman
Aaron B
AB
Department of Medicine, Section of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53713, USA.
Gimelli
Giorgio
G
Yevzlin
Alexander S
AS
D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D005260:Female; D006225:Hand / Q000098:blood supply*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000009:adverse effects; D007511:Ischemia / Q000209:etiology* / Q000628:therapy*; D008323:Mammary Arteries; D008875:Middle Aged; D012039:Regional Blood Flow; D006435:Renal Dialysis