title: Femoral Arteriovenous Fistula Associated With Leg Swelling 6 Months After Removal of a Hemodialysis Catheter: A Case Report.
abstract: Double-lumen catheters have been used widely to obtain temporary access in patients who are in need of acute hemodialysis (HD) because of acute renal failure. Several complications are associated with the insertion of these catheters, including bleeding, infection, injuries to arteries, and deep venous thrombosis. An arteriovenous fistula (AVF) is a rare but significant complication following catheterization for temporary HD. Herein, we present a case of AVF associated with leg swelling 6 months after the removal ofa double-lumen HD catheter. We describe a special case of a 42-year-old man who experienced acute renal failure secondary to diabetic ketoacidosis (DKA). A 12-Fr dialysis catheter was inserted in the right femoral vein. Six months after catheter removal, the patient was admitted for pain and swelling in the right leg. Color Doppler ultrasound and three-dimensional computed tomography (CT) revealed an AVF between the right femoral vein and the right femoral superficial artery. The fistula was repaired successfully by vascular surgeons. This case highlights that an AVF is a rare but significant complication after catheterization for temporary HD. The nephrologist should be wary of the potential of this complication and perform clinical and medical examinations at the insertion and removal of temporary HD catheters.
authors.affiliation: From the Department of Nephrology (LJ, WL); Department of Vascular and Endovascular Surgery, Department of General surgery Lishui Hospital of Zhejiang University, Zhejiang (JW); Department of Infection Diseases, The First Hospital of Quanzhou affiliated to Fujian Medical University, Fujian (XY); and Department of Nephrology, Qingyuan People's hospital, Zhejiang Province, China (CW).
authors.forename: Lie
authors.initials: L
authors.lastname: Jin
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Chuifen
authors.initials: C
authors.lastname: Wu
authors.forename: Chuxiao
authors.initials: C
authors.lastname: Shao
authors.forename: Xueping
authors.initials: X
authors.lastname: Yu
authors.forename: Wenhui
authors.initials: W
authors.lastname: Lei
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000628:therapy*; D000328:Adult; D001164:Arteriovenous Fistula / Q000209:etiology* / Q000601:surgery; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D016883:Diabetic Ketoacidosis / Q000150:complications; D005268:Femoral Vein; D006801:Humans; D008297:Male; D006435:Renal Dialysis / Q000379:methods*