IATROGENIC ARTERIOVENOUS-FISTULA AS A COMPLICATION OF A POLYTETRAFLUOROETHYLENE (PTFE) GRAFT FOR HEMODIALYSIS - CASE-REPORTS

The authors describe 2 patients who developed an iatrogenic arterioven ous fistula between a straight forearm polytetrafluoroethylene (PTFE) graft and an in situ cephalic vein after posterior puncture of the gra ft with a hemodialysis cannula. Diagnosis of this iatrogenic fistula w as by careful inspection of the PTFE graft. The distal PTFE graft was functional, but the proximal graft was thrombosed at the ill-placed pu ncture site. Superficial veins on the anterior forearm exhibited a thr ill and bruit. Treatment was simple ligation of the fistula and revasc ularization of the thrombosed segment of the PTFE graft. When the fist ula occurred with a pseudoaneurysm, treatment was ligation of the fist ula, exclusion of the pseudoaneurysm, and interposition graft to maint ain vascular continuity. This complication of vascular access is not d ocumented in the literature.