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Vascular and Endovascular Surgery
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Iatrogenic Arteriovenous Fistula as a Complication of a Polytetrafluoroethylene (PTFE) Graft for Hemodialysis

Case Reports

Robert M. Esterl, JR

Department of Surgery, University of Texas Health Science Center at San Antonio, Department of Surgery, Saint Louis University, Saint Louis, Missouri

Paul J. Garvin

Department of Surgery, University of Texas Health Science Center at San Antonio, Department of Surgery, Saint Louis University, Saint Louis, Missouri

The authors describe 2 patients who developed an iatrogenic arteriovenous fistula between a straight forearm polytetrafluoroethylene (PTFE) graft and an in situ cephalic vein after posterior puncture of the graft with a hemodialysis cannula. Diagnosis of this iatrogenic fistula was by careful inspection of the PTFE graft. The distal PTFE graft was functional, but the proximal graft was thrombosed at the ill-placed puncture site. Superficial veins on the anterior forearm exhibited a thrill and bruit. Treatment was simple ligation of the fistula and revascularization of the thrombosed segment of the PTFE graft. When the fistula occurred with a pseudoaneurysm, treatment was ligation of the fistula, exclusion of the pseudoaneurysm, and interposition graft to maintain vascular continuity. This complication of vascular access is not documented in the literature.

Vascular and Endovascular Surgery, Vol. 31, No. 2, 175-178 (1997)
DOI: 10.1177/153857449703100210
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