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Carotid-jugular arteriovenous fistula: a case report of an iatrogenic complication following internal jugular vein catheterization for hemodialysis access
Authors:Patel Himanshu V  Sainaresh Vellanki V  Jain Siddharth H  Kute Vivek B  Godara Suraj  Gumber Manoj R  Munjappa Bipin  Gera Dinesh N  Shah Pankaj R  Trivedi Hargovind L
Affiliation:Department of Nephrology and Transplantation, Smt Gulabben Rasiklal Doshi and Smt Kamlaben Mafatlal Mehta Institute Of Kidney Diseases & Research Centre, Dr H L Trivedi Institute Of Transplantation Sciences, Ahmedabad, Gujarat, India.
Abstract:We report a case of diabetic end-stage renal disease patient who presented with a right common carotid artery jugular arteriovenous fistula as a complication of the insertion of a polyurethane double-lumen hemodialysis catheter into the right internal jugular vein .On physical examination of the neck, a pulsating mass with a palpable thrill and a bruit was noted in the right subclavicular region. The diagnosis was confirmed by color doppler ultrasonography of the neck and carotid angiography. The review of the literature suggests the occurrence of this complication as rather rare. The fistula was successfully repaired surgically. It is emphasized that while securing the access, a thorough physical examination with a special emphasis on seeking any neck swellings, thrill, and bruit along with routine use of vascular doppler for securing dialysis access is recommended.
Keywords:Carotid‐jugular arteriovenous fistula  chronic renal failure  hemodialysis catheter  complications
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