Rupture of a pseudoaneurysm in brachial artery after hemodialysis therapy: rare but serious complication

Abstract

Pseudoaneurysm (PSA) is a common complication that may occur on the AV fistula line. However, the 5 development of the PSA on a wrong cannulated brachial artery is a rarely seen and catastrophic 6 complication as occured in this case. Rupture is one of the serious complication of PSA. In our case 64 years old male with left snuff-box arteriovenous fistula (AVF) refer to emergency service with pain, swelling, tension on left arm after hemodialysis session. Doppler ultrasound confirmed brachial artery ruptured PSA active bleeding in to the approximately 4 cm diameter hematoma. The patient was transferred to the operating room and underwent to surgery for ruptured PSA repair. Four weeks after surgery, the arteriovenous fistula was used as an access for hemodialysis. Left hand 1st and 2nd digits distal phalanx flexion was limited Clinical suspicion, physical examination, and Doppler ultrasound are essential for early diagnosis and for optimal treatment. Doppler ultrasound can detect the lesion accurately. In patients with arteriovenous fistula during hemodialysis it should be considered pseudoaneurysm, rupture and neuropathy may occur. These are rare but serious complications so suspicion, clinical examination and doppler ultrasound are very important for early diagnosis and treatment.

Keywords

• Hemodialysis
• brachial artery pseudoaneurysm
• pseudoaneurysm rupture

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