title: Massive intravascular hemolysis with mechanical rheolytic thrombectomy of a hemodialysis arteriovenous fistula.
abstract: A 57-year-old man with chronic kidney disease stage 5 presented for ambulatory evaluation of his arteriovenous fistula. He underwent rheolytic thrombectomy with tissue plasminogen activator infusion, angioplasty, and brachial artery stenting under local sedation. His immediate postoperative course was complicated by hypotension, cardiac dysrhythmias and hyperkalemia requiring emergent hemodialysis, due to severe intravascular hemolysis. This case illustrates that mechanical thrombectomy can cause clinically significant intravascular hemolysis, thus careful postoperative monitoring is recommended.
authors: Division of Nephrology, Department of Medicine, Lenox Hill Hospital, New York, New York, USA. louie9877@gmail.com
authors: Louis A
authors: LA
authors: Carrera
authors: Rachita
authors: R
authors: Reddy
authors: Vicken N
authors: VN
authors: Pamoukian
authors: Michael F
authors: MF
authors: Michelis
authors: Maria V
authors: MV
authors: DeVita
authors: Jordan
authors: J
authors: Rosenstock
mesh_terms: D001166:Arteriovenous Shunt, Surgical; D006461:Hemolysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D061185:Mechanical Thrombolysis / Q000379:methods*; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D013923:Thromboembolism / Q000209:etiology / Q000628:therapy*; D017211:Treatment Failure