A Case of Brachiocephalic Fistula Steal and the Emergency Physician's Approach to Hemodialysis Arteriovenous Fistula Complications

摘要: Abstract Background Chronic kidney disease is common in the United States, with many patients maintained on hemodialysis (HD). The process of HD requires vascular access through an arteriovenous (AV) fistula, AV graft, or central venous catheter. Today, as a result National Kidney Foundation's “Fistula First” initiative, nearly 55% utilize fistula. As there significant morbidity and mortality associated fistula placement recurrent cannulation, emergency physicians must be equipped to recognize treat complications. Objective To detail case study insufficiency (vascular steal) presenting department (ED) provide evidence-based approach assessment management Discussion A 66-year-old man presented ED left upper extremity pain, paresthesias, loss grip strength 1-week duration 15 days after brachiocephalic He was diagnosed dialysis access-associated steal syndrome taken operating room for revision. Patients fistulas may experience several complications, including insufficiency, hemorrhage, infection, stenosis, thrombosis, aneurysms, pseudoaneurysms. Emergency able identify these complications deliver timely treatment. Conclusions comprehensive understanding appropriate paramount physician. Early recognition treatment resulting from creation, aneurysms pseudoaneurysms vital reducing HD.