Ba. Standage et al., SINGLE LIMB PATENCY OF POLYTETRAFLUOROETHYLENE DIALYSIS LOOP GRAFTS MAINTAINED BY TRAUMATIC FISTULIZATION, Annals of vascular surgery, 12(4), 1998, pp. 364-369
Citations number
7
Categorie Soggetti
Surgery,"Peripheal Vascular Diseas","Cardiac & Cardiovascular System
The purpose of this report is to describe an unusual presentation of o
bstructive neointimal hyperplastic lesions in loop prosthetic dialysis
grafts. The case histories and imaging studies of two patients with p
artial graft thrombosis are presented. The literature of unexpected fi
stulae from prosthetic dialysis grafts to adjacent veins is reviewed.
Signs and symptoms that would lead a clinician to suspect the diagnosi
s are emphasized. There were two dialysis grafts with partial thrombos
is and arterial limb patency maintained by iatrogenic fistula. These f
istulae occurred from the erosion of pseudoaneurysms in one case and a
n apparent needle stick without pseudoaneurysm in the other. Both graf
ts had high-grade stenotic lesions affecting the venous outflow. In th
e first case this was not recognized until the graft reclotted 2 days
after thrombectomy. In the most extreme cases of graft/vein fistulae,
i.e., partial graft thrombosis with arterial limb patency maintained b
y the fistula there is always associated venous anastomotic or outflow
stenoses which must be addressed.