title: Severe hemorrhage because of delayed iliac vein rupture after dialysis catheter placement: is it preventable?
abstract: Mechanical complications of femoral catheterization for hemodialysis include pseudoaneurysm, arteriovenous fistulae, neurological injury, and vessel perforation. With regard to the latter, severe hemorrhage is a rare but devastating and potentially fatal complication. We report the case of a 76-year-old female who underwent femoral catheterization for hemodialysis using ultrasound guidance. The first hemodialysis session was conducted without incident. Unfortunately, inadvertent injury and delayed perforation of the iliac vein resulted in severe hemorrhage and retroperitoneal hematoma. Surgical repair was performed. The patient was asymptomatic after the procedure and was discharged 15 days later. Based on this case and a review of the literature, we present mechanisms and ways to prevent this complication.
authors.affiliation: Nephrology Section, Hospital General Universitario de Elche, Elche, Spain. anaesipe@gmail.com
authors.forename: Ana E
authors.initials: AE
authors.lastname: Sirvent
authors.forename: Ricardo
authors.initials: R
authors.lastname: Enríquez
authors.forename: Isabel
authors.initials: I
authors.lastname: Millán
authors.forename: Jose M
authors.initials: JM
authors.lastname: García-Marco
authors.forename: Elías
authors.initials: E
authors.lastname: Rodríguez-Czaplicki
authors.forename: Maria D
authors.initials: MD
authors.lastname: Redondo-Pachón
authors.forename: César
authors.initials: C
authors.lastname: González
authors.forename: Francisco
authors.initials: F
authors.lastname: Amorós
mesh_terms: D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D005268:Femoral Vein / Q000601:surgery; D006801:Humans; D007084:Iliac Vein / Q000293:injuries* / Q000601:surgery; D006435:Renal Dialysis / Q000009:adverse effects*; D012421:Rupture