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Iatrogenic post-catheterization radial arteriovenous fistula in 64-old male patient

Rbert Novotny, Jaroslav Hlubocky, Petr Mitas, Jan Hruby, Miroslav spacek, Rudolf spunda, Jan Tosovsky and Jaroslav Lindner

Background: We are presenting a case report of an iatrogenic left radial post-catheterization arteriovenous fistula. A 64-year-old male patient one year after percutaneous coronary intervention (PCI) with coronary stent implants was admitted with a pulsatile, palpable mass with bruit and intermittent pain in the region of the left radial artery. Finding: Ultrasonography of the left radial artery was performed, confirming a radial arteriovenous fistula (AVF) in the place of PCI. Method: Percutaneous embolization (PE) with thrombin was chosen as a treatment of choice based on the anatomical localization and characteristics of the AVF. The PE treatment was repeated twice with suboptimal post-procedural result. One day after the PE an ultrasonographic check-up was performed, confirming a suboptimal result of PE with a light palpable bruit present in the place of the AVF. Patient was indicated for surgical resection. After the surgical resection, patient was immediately relieved of all accompanying symptoms and was discharged two days after the procedure. Conclusion: The preferred treatment of choice for post-catheterization arteriovenous fistulas is percutaneous embolization. Surgical resection of post-catheterization AVF is used only when all percutaneous treatments fail.