ABSTRACT
Hypothenar hammer syndrome (HHS) is an uncommon condition that is associated with occupational repetitive injury to the hand. The commonly associated occupations include auto mechanics, machinists, miners, and butchers or occupations requiring the worker to use the hypothenar portion of the hand as a tool. Until now, there has never been a case report of HHS secondary to firearm use. In this report, we highlight a unique presentation of firearm-related HHS.
ABSTRACT
INTRODUCTION: Iatrogenic arteriovenous fistula is a vascular condition that may result from coronary angiography. Many case reports have described arteriovenous fistula occurrence after coronary angiography using the transfemoral access route, but rarely as a complication of using the transradial approach. We report a rare case of a patient with arteriovenous fistula following transradial artery coronary angiography. CASE PRESENTATION: A 62-year-old Caucasian man underwent emergent coronary angiography using the right radial artery approach. One month after angiography, he discovered a turbulent sound near the access site. A right radial arteriovenous fistula was found upon duplex ultrasound investigation. The patient was treated conservatively. At 1-year follow-up, the arteriovenous fistula was unchanged and the patient remained hemodynamically stable and asymptomatic. CONCLUSION: Iatrogenic arteriovenous fistula is a rare vascular complication of transradial artery coronary angiography. The natural history of arteriovenous fistula is benign and is thought to resolve spontaneously; therefore, a conservative approach, as opposed to surgical ligation, is recommended as the first-line treatment.