Blood Loss through AV Fistula A Case Report and Literature Review英文文献资料.docVIP

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Blood Loss through AV Fistula A Case Report and Literature Review英文文献资料.doc

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Blood Loss through AV Fistula A Case Report and Literature Review英文文献资料

SAGE-HindawiAccesstoResearch InternationalJournalofNephrology Volume2011,ArticleID350870,6pages doi:10.4061/2011/350870 ReviewArticle BloodLossthroughAVFistula: ACaseReportandLiteratureReview FahadSaeed,NadiaKousar,RamapriyaSinnakirouchenan,VijayaS.Ramalingam, PhilipB.Johnson,andJeanL.Holley CollegeofMedicineatUrbana-Champaign,UniversityofIllinois,611WParkStreet,Urbana,IL61801,USA CorrespondenceshouldbeaddressedtoFahadSaeed,fahadsaeed20@ Received3January2011;Revised10March2011;Accepted24March2011 AcademicEditor:GregTesch Copyright?2011FahadSaeedetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. Littlehasbeenwrittenaboutacutebloodlossfromhemodialysisvascularaccess.Wedescribea57-year-oldCaucasianmalewithan approximately7gm/dLdropinhemoglobinduetobleedingfromarupturedaneurysminhisrightbrachiocephalicarteriovenous ?stula(AVF).Therewasnoevidenceof?stulainfection.Thepatientwassuccessfullymanagedbybloodtransfusionsandinsertion ofatunneleddialysiscatheterfordialysisaccess.Later,the?stulawasligatedandanew?stulawasconstructedintheopposite arm.Aneurysmshouldbeconsideredincasesofacutevascularaccessbleedinginchronicdialysispatients. 1.Introduction when he underwent an AV ?stulogram due to decreased dialysis clearance. The ?stulogram identi?ed two areas of venousstenosisandananeurysmaldilatationintheproximal portion of the out?ow vein. No central vein stenosis was seen. Successful angioplasty of the two sequential stenoses was performed with establishment of good ?stula ?ow. Fivemonthsafterthisprocedure,prolonged?stulableeding afteraroutinedialysisledtoanotherAV?stulogramwhich demonstratedarecurrentstenosisoftheout?owtractinthe cephalicvein.Angioplastywasagainsuccessfullyperformed with no visible residual stenosis on postoperative ?stulo- gram. No routine access ?ow monitoring was performed in the dialysis unit. No signi?cant dialysis acce