title: Postcatheterization radial arteriovenous fistula: balloon-assisted direct percutaneous embolization with N-butyl cyanoacrylate and 50 % glucose solution in two sessions.
abstract: We report an iatrogenic radial arteriovenous fistula (AVF) in a 74-year-old woman presenting with right radial bruit and pain 8 months after sheath removal for cardiac catheterization. She refused surgical ligation and underwent balloon-assisted direct percutaneous embolization of the draining vein with N-butyl cyanoacrylate (NBCA). Another draining vein that developed immediately after the procedure was conservatively treated with 1 month of continuous band compression. However, its diameter gradually increased and, as the patient desired complete remission, an additional procedure was conducted 2 months after initial treatment. A second balloon-assisted direct percutaneous embolization was performed using a 50 % glucose solution, which resulted in complete resolution. Although surgical repair is considered to be the standard treatment, in patients where surgery is not indicated, endovascular intervention-although complicated-may be an alternative treatment modality.
authors.affiliation: Department of Radiology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamine-minami, Higashi-ku, Kumamoto, 861-8520, Japan. sugatake@kumamoto-med.jrc.or.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugahara
authors.forename: Minako
authors.initials: M
authors.lastname: Azuma
authors.forename: Koya
authors.initials: K
authors.lastname: Nakashima
authors.forename: Kanako
authors.initials: K
authors.lastname: Ito
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Suzuki
authors.forename: Koji
authors.initials: K
authors.lastname: Hagio
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uetani
authors.forename: Yumi
authors.initials: Y
authors.lastname: Yanaga
authors.forename: Yuji
authors.initials: Y
authors.lastname: Baba
mesh_terms: D000368:Aged; D001164:Arteriovenous Fistula / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy*; D021721:Balloon Occlusion / Q000379:methods*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D020878:Device Removal / Q000009:adverse effects; D003952:Diagnostic Imaging; D004659:Enbucrilate / Q000627:therapeutic use; D005260:Female; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007049:Iatrogenic Disease; D017534:Radial Artery
chemical_list: D004659:Enbucrilate; D005947:Glucose