Femoral arteriovenous fistula 3 months after removal of catheter for hemodialysis.

ABSTRACT

A 56-year-old Asian woman was admitted to hospital for the consideration of hemodialysis (HD). A right femoral dialysis catheter was inserted for HD. Three months after removal of catheter, she was admitted because of right inguinal swelling. A thrill and bruit were felt and heard at the inguinal area. Color Doppler detected a fistula between right superficial femoral artery and right common femoral vein and subsequently confirmed by contrast enhanced computed tomography scan and 3-dimensional reconstruction with computed tomography. At surgery, a 4-mm-diameter fistula was found between the right superficial femoral artery and right common femoral vein. A primary closure of both defects in the artery and vein was then carried out. A follow-up digital vascular study 3 months after surgical repair was normal. In conclusion, nephrologist should have a heightened awareness to the potential of this complication and should at least document a normal exam following the removal of femoral catheters.