Arterial injuries following diagnostic, therapeutic, and accidental arterial cannulation in haemodialysis patients |
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Authors: | Cina G; De Rosa MG; Viola G; Tazza L |
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Institution: | Catholic University School of Medicine, Department of Surgery, Rome, Italy. |
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Abstract: | BACKGROUND: Incidence of iatrogenic arterial lesions is currently
increasing and patients undergoing dialysis represent a group at high risk
since they require repeated cannulation of the vascular access and
intermittent heparinization during maintenance haemodialysis. CLINICAL
REPORTS: Between 1992 and 1995 we treated four vascular lesions (two
pseudoaneurysms and two arteriovenous fistulae) with surgery in three
patients undergoing dialysis at our centre. No postoperative morbidity and
mortality was observed; in all cases surgery was effective. CONCLUSIONS:
Although conservative treatment (US guided compression) of arterial lesions
shows promising results, in patients undergoing dialysis combined with
heparinization it seems less suitable. In these patients, early detection
of post-cannulation pseudoaneurysms or arteriovenous fistulae allows
surgical treatment, with low morbidity rate and satisfactory long-term
outcome.
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