Postcatheterization radial arteriovenous fistula: balloon-assisted direct percutaneous embolization with N-butyl cyanoacrylate and 50 % glucose solution in two sessions

We report an iatrogenic radial arteriovenous fistula (AVF) in a 74-year-old woman presenting with right radial bruit and pain 8 months after sheath removal for cardiac catheterization. She refused surgical ligation and underwent balloon-assisted direct percutaneous embolization of the draining vein...

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Bibliographic Details
Published in:Japanese journal of radiology 2013-07, Vol.31 (7), p.505-510
Main Authors: Sugahara, Takeshi, Azuma, Minako, Nakashima, Koya, Ito, Kanako, Suzuki, Ryusuke, Hagio, Koji, Uetani, Hiroyuki, Yanaga, Yumi, Baba, Yuji
Format: Article
Language:English
Subjects:
Aged
Arteriovenous Fistula - diagnosis
Arteriovenous Fistula - etiology
Arteriovenous Fistula - therapy
Balloon Occlusion - methods
Cardiac Catheterization - adverse effects
Case Report
Device Removal - adverse effects
Diagnostic Imaging
Enbucrilate - therapeutic use
Female
Glucose - therapeutic use
Humans
Iatrogenic Disease
Imaging
Medicine
Medicine & Public Health
Nuclear Medicine
Radial Artery
Radiology
Radiotherapy
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Summary:We report an iatrogenic radial arteriovenous fistula (AVF) in a 74-year-old woman presenting with right radial bruit and pain 8 months after sheath removal for cardiac catheterization. She refused surgical ligation and underwent balloon-assisted direct percutaneous embolization of the draining vein with N -butyl cyanoacrylate (NBCA). Another draining vein that developed immediately after the procedure was conservatively treated with 1 month of continuous band compression. However, its diameter gradually increased and, as the patient desired complete remission, an additional procedure was conducted 2 months after initial treatment. A second balloon-assisted direct percutaneous embolization was performed using a 50 % glucose solution, which resulted in complete resolution. Although surgical repair is considered to be the standard treatment, in patients where surgery is not indicated, endovascular intervention—although complicated—may be an alternative treatment modality.
ISSN:1867-1071
1867-108X
DOI:10.1007/s11604-013-0206-8