Arteriovenous fistula complicating access

Abstract

There are two main causes of iatrogenic arteriovenous fistula (AVF) formation related to peripheral endovascular procedures. AVF may be puncture-site related and may occur during arterial revascularization procedures. The reported incidence of post-femoral catheterization AVF is very low and ranges from 0.006 to 0.5 %, whereas reported data about AVF occurring during balloon angioplasty are scarce. The diagnosis of femoral AVF can be made by palpation and auscultation. Clinical symptoms include pain, femoral thrill and haematoma, while Doppler ultrasonography can confirm the diagnosis. In the majority of the cases, the prognosis of an uncomplicated AVF is good, as most of the lesions present with moderate clinical symptoms and may resolve spontaneously. However, in rare cases of large AVF that is associated with aneurysmal expansion, more serious complications such as ischaemia from steal syndrome, high output cardiac failure and limb oedema may develop.