Case Report

A Rare Case of Transradial Coronary Angiography Resulting in Arteriovenous Fistula

Ahmad Alshatti, Hussain Alzayer and JD Schwalm*

¹The Population Health Research Institute, McMaster University, Canada

Submission: March 04, 2017; Published: March 23, 2017

*Corresponding author: JD Schwalm, The Population Health Research Institute, McMaster University, Hamilton Health Sciences, DBCVSRI, C3-108, 237 Barton Street East, Hamilton, ON L8L 2X2, Canada, Fax: 905-577-1474; Tel:905-577-1423; Email: Schwalj@mcmaster.ca

How to cite this article: Ahmad A, Hussain A, J Schwalm. A Rare Case of Transradial Coronary Angiography Resulting in Arteriovenous Fistula. J Cardiol & Cardiovasc Ther 2017; 3(5): 555621. DOI:10.19080/JOCCT.2017.03.555621

Abstract

A 79-year-old male presented with chest pain and electrocardiographic evidence of inferior ST elevation myocardial infraction (STEMI). He underwent primary percutaneous coronary intervention via radial approach. Following the procedure he developed swelling at the access site and a bruit was heard. Ultrasonography demonstrated an arteriovenous fistula. He was managed conservatively and was seen few weeks later with complete resolution of his symptoms.

Keywords: Radial artery; Arteriovenous fistula; Angiography

Case Report

Discussion

Transradial coronary angiography has significantly reduced access site complications. AVF is an abnormal connection between the arterial and venous systems. AVF is an extremely rare complication following the transradial approach and has been reported only in few cases [1-4]. On the other hand, AVF is a well-known complication of the transfemoral approach. The diagnosis is usually made by color Doppler ultrasonography.

Treatment options include surgical repair, endovascular intervention, ultrasound-guided compression and conservative treatment. The majority of reported cases have been treated surgically. Of the two cases not treated surgically, one was treated with endovascular intervention [4] and the other was treated conservatively [2]. There is no consensus regarding the preferred treatment option. However, to our knowledge, this is the second case of iatrogenic radial AVF, which was treated successfully in a conservative fashion. This case highlights conservative therapy as a reasonable alternative to surgical therapy in selected patients with iatrogenic radial AVF

References

1. Goldberg A, Tsipis A, Rosenfeld I (2013) Arteriovenous fistula after cardiac catheterization from a radial approach. Isr Med Assoc J 15(6): 313-314.
2. Görgülü S, Norgaz T, Sahingöz Y (2013) A case of radial arteriovenous fistula during coronary angiography. Anadolu Kardiyol Derg 13(2): 181-182.
3. Yang JH, Gwon HC, Park JE, Song YB (2012) Arteriovenous fistula of the wrist after transradial coronary intervention. Heart Lung 41(2): 203-206.
4. Sugahara T, Azuma M, Nakashima K, Ito K, Suzuki R, et al. (2013) Postcatheterization radial arteriovenous fistula: balloon-assisted direct percutaneous embolization with N-butyl cyanoacrylate and 50% glucose solution in two sessions. Jpn J Radiol 31(7): 505-510.