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Vein wall dissection: A rare puncture‐related complication of brachiocephalic fistula. Gray‐scale and color Doppler sonographic findings
Author(s) -
Salgado Octavio J.,
Chacón Rosa E.,
Alcalá Armando,
Alvarez Gerardo
Publication year - 2005
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.20171
Subject(s) - medicine , complication , color doppler , fistula , radiology , surgery , brachiocephalic vein , dissection (medical) , ultrasonography , superior vena cava
We describe a case of brachiocephalic fistula vein wall dissection (VWD) occurring in a 36‐year‐old female hemodialysis patient. Unlike subcutaneous or subfascial infiltrations for which the mechanism is blood extravasation, VWD seems to be due to disruption of the fistula vein layers caused by misplacement of the outflow (venous) needle bevel. In this setting, the pressure of the dialysis blood pump acts as the driving force of the dissecting column, extending it proximally. Gray‐scale and color Doppler sonography proved to be very useful in the differential diagnosis of VWD, particularly with thrombosis of the fistula. Sonography also helped us decide when to resume cannulations. © 2005 Wiley Periodicals, Inc. J Clin Ultrasound 33 :464–467, 2005