Retrograde dissection of the axillary artery during arteriogram via arteriovenous access.
BACKGROUND
Retrograde arterial dissection is a recognized complication of endovascular intervention but has not been well reported especially in the context of dialysis arteriovenous access procedures. The management of this complication is also not well defined.


METHODS
We report the case of an 80-year-old female with end-stage renal disease (ESRD) on dialysis who developed an asymptomatic retrograde dissection of the left axillary artery during an arteriogram performed via a retrograde approach as part of access dysfunction evaluation. The condition was managed conservatively with no other intervention and close follow-up. No surgical intervention or stenting was needed in this case.


CONCLUSIONS
Conservative management of retrograde arterial dissection in the arm may be a viable option especially in asymptomatic patients due to the nature of the injury. The force of blood flow in the antegrade direction limits the expansion of the false lumen and likely promotes the spontaneous healing of the vessel.
University of Illinois College of Medicine, Chicago, IL - USA.
Daven
D
Patel
University of Illinois College of Medicine, Chicago, IL - USA.
Vinaya
V
Soundararajan
Midwestern University College of Medicine, Downers Grove, IL - USA.
Ramesh
R
Soundararajan
D000369:Aged, 80 and over; D000792:Angiography / Q000009:adverse effects*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001366:Axillary Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D012039:Regional Blood Flow; D006435:Renal Dialysis; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D014945:Wound Healing