Fístula arteriovenosa pós-cateterismo radial com repercussões cardiopulmonares
Arteriovenous fistula after radial catheterization with cardiopulmonary repercussions
Alexandre Faraco de Oliveira; Alexandre David Ribeiro; Marcio Costa Silveira Ávila
Resumo
Palavras-chave
Abstract
Abstract: This article describes the case of an 86-year-old coronary disease patient who underwent cardiac catheterization via a left radial access. Around 16 months after the procedure, he presented with dyspnea, unrelated to effort, but associated with nocturnal hypoxia. There was a palpable thrill in the left wrist and he was diagnosed with a radiocephalic arteriovenous fistula in the left wrist. A duplex scan revealed an abnormal wave pattern and increased diastolic velocity compatible with arteriovenous fistula. The fistula was repaired surgically and the patient exhibited improvement in clinical and laboratory parameters after the procedure. Radial access is increasingly being used for cardiac catheterization, primarily because it is associated with fewer and less harmful complications than femoral access. However, complications such as arteriovenous fistula occur and can be particularly harmful in octogenarian patients.
Keywords
References
Kolkailah AA, Alreshq RS, Muhammed AM, Zahran ME, Anas El-Wegoud M, Nabhan AF. Transradial versus transfemoral approach for diagnostic coronary angiography and percutaneous coronary intervention in people with coronary artery disease. Cochrane Database Syst Rev. 2018;4:CD012318. PMid:29665617.
Rigattieri S, Sciahbasi A, Ratib K, et al. Comparison between radial approach and femoral approach with vascular closure devices on the occurrence of access. J Invasive Cardiol. 2016;28(12):473-9. PMid:27630147.
Basu D, Singh PM, Tiwari A, Goudra B. Meta-analysis comparing radial versus femoral approach in patients 75 years and older undergoing percutaneous coronary procedures. Indian Heart J. 2017;69(5):580-8. http://dx.doi.org/10.1016/j.ihj.2017.02.003. PMid:29054180.
Brueck M, Bandorski D, Kramer W, Wieczorek M, Höltgen R, Tillmanns H. A randomized comparison of transradial versus transfemoral approach for coronary angiography and angioplasty. JACC Cardiovasc Interv. 2009;2(11):1047-54. http://dx.doi.org/10.1016/j.jcin.2009.07.016. PMid:19926042.
Carvalho MS, Calé R, Gonçalves PA, et al. Predictors of conversion fron radial into femoral Access in cardiac catheterization. Arq Bras Cardiol. 2015;104(5):401-8. PMid:25789883.
Tatli E, Buturak A, Cakar A, et al. Unusual vascular complications associated with transradial coronary procedures among 10,324 patients: case based experience and treatment options. J Interv Cardiol. 2015;28(3):305-12. http://dx.doi.org/10.1111/joic.12206. PMid:25989895.
Pilan BF, Oliveira AM, Siqueira DED, Guillaumon AT. Tratamento de fístula arteriovenosa adquirida com repercussões hemodinâmicas graves: desafio terapêutico. J Vasc Bras. 2014;13(1):34-. http://dx.doi.org/10.1590/jvb.2014.007.
Alkhouli M, Sandhu P, Boobes K, Hatahet K, Raza F, Boobes Y. Cardiac complications of arteriovenous fistulas in patients with end-stage renal disease. Nefrologia. 2015;35(3):234-45. http://dx.doi.org/10.1016/j.nefro.2015.03.001. PMid:26299166.
Wang EA, Lee MH, Wang MC, Lee HY. Iatrogenic left iliac caval fistula: imaging and endovascular treatment. AJR Am J Roentgenol. 2004;183(4):1032-4. http://dx.doi.org/10.2214/ajr.183.4.1831032. PMid:15385299.
Yared K, Baggish AL, Wood MJ. High-output heart failure resulting from a remote traumatic arteriovenous fistula. Can J Cardiol. 2009;25(4):e143-4. http://dx.doi.org/10.1016/S0828-282X(09)70083-2. PMid:19340363.