NDLI: Ipsilateral jugular access to treat an otherwise inaccessible puncture-related arteriovenous fistula pseudoaneurysm: a technical note.

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Ipsilateral jugular access to treat an otherwise inaccessible puncture-related arteriovenous fistula pseudoaneurysm: a technical note.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Rabellino, Martin Rosa-Diez, Guillermo Peralta, Oscar Shinzato, Sergio Crucelegui, Maria Soledad Serra, Diego Garcia-Monaco, Ricardo
Description	Author Affiliation: Rabellino M ( Department of Angiography and Endovascular Therapy, Hospital Italiano de Buenos Aires, Buenos Aires - Argentina.)
Abstract	BACKGROUND: The standard approach for the endovascular treatment of a dysfunctional or occluded hemodialysis access in the upper limbs includes a direct intervention through the access itself or alternatively, when not feasible, through the brachial or radial artery access. Nonetheless, there are certain circumstances in which these approaches are not easily achieved. METHODS: An 89-year-old male with end-stage renal disease developed a pseudoaneurysm after an hemorrhagic complication of a recently transposed native basilic arteriovenous fistula secondary to a needle puncture. Dehiscence of the injured access with spontaneous arterial bleeding evolved as a consequence of the upper limb swelling, rendering therapeutic intervention of the access through a conventional route impossible. A fistulogram through puncture of the common femoral artery was performed to obtain an accurate diagnosis. However, this approach was insufficient to advance the covered stent with the intention of excluding the pseudoaneurysm, as the stent delivery system could not reach the desired site. Given that the covered stent insertion required a 9 Fr introducer, the radial artery approach was ruled out. Therefore, we chose a venous access via the ipsilateral internal jugular vein, which was punctured under ultrasound guidance. RESULTS: This strategy was useful to advance the stent and exclude the pseudoaneurysm successfully. CONCLUSIONS: This technique should be considered for those individuals in whom conventional routes of approach for repairing dialysis accesses are not feasible or are extremely risky.
File Format	HTM / HTML
ISSN	11297298
Issue Number	1
Volume Number	15
e-ISSN	17246032
Journal	The Journal of Vascular Access
Language	English
Publisher	Sage Publications
Publisher Date	2014-01-01
Publisher Place	Italy
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Vascular Diseases Aneurysm, False Therapy Arteriovenous Shunt, Surgical Adverse Effects Catheterization, Central Venous Methods Endovascular Procedures Jugular Veins Kidney Failure, Chronic Renal Dialysis Upper Extremity Blood Supply Aged, 80 And Over Diagnosis Etiology Instrumentation Humans Male Predictive Value Of Tests Punctures Stents Ultrasonography, Interventional Case Reports Journal Article
Content Type	Text
Resource Type	Case study Article
Subject	Surgery Nephrology

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Ipsilateral jugular access to treat an otherwise inaccessible puncture-related arteriovenous fistula pseudoaneurysm: a technical note.

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Ipsilateral jugular access to treat an otherwise inaccessible puncture-related arteriovenous fistula pseudoaneurysm: a technical note.