Arterial angioplasty to treat hand ischemia in a radial-cephalic fistula

Antoine Samaha, Loay Salman, Arif Asif

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

A chronic hemodialysis patient was referred to interventional nephrology for evaluation of left hand pain. The patient had been receiving hemodialysis through a left radial-cephalic arteriovenous fistula and reporting hand pain during dialysis. Physical examination demonstrated cold hand and reduced capillary refill compared with the right hand. Clinical features, differential diagnosis, and physical examination findings were consistent with the diagnosis of hand ischemia due to dialysis access. Arteriography revealed >80% stenosis of the distal ulnar artery. Percutaneous balloon angioplasty successfully dilated the lesion with resolution of symptoms. Although uncommon, patients with forearm fistula can also experience symptoms of hand ischemia. This case demonstrates that in addition to the history, clinical features, differential diagnosis, and physical examination, arteriography is a vital step in the management of patients presenting with signs and symptoms of hand ischemia. Further, employment of a basic procedure (percutaneous balloon angioplasty) can successfully resolve the condition and maintain the dialysis access.

Original languageEnglish
Pages (from-to)561-563
Number of pages3
JournalSeminars in Dialysis
Volume22
Issue number5
DOIs
StatePublished - Sep 1 2009

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Angioplasty
Fistula
Ischemia
Hand
Head
Physical Examination
Dialysis
Balloon Angioplasty
Renal Dialysis
Angiography
Differential Diagnosis
Ulnar Artery
Pain
Nephrology
Arteriovenous Fistula
Forearm
Signs and Symptoms
Pathologic Constriction
History

ASJC Scopus subject areas

  • Nephrology

Cite this

Arterial angioplasty to treat hand ischemia in a radial-cephalic fistula. / Samaha, Antoine; Salman, Loay; Asif, Arif.

In: Seminars in Dialysis, Vol. 22, No. 5, 01.09.2009, p. 561-563.

Research output: Contribution to journalArticle

Samaha, Antoine ; Salman, Loay ; Asif, Arif. / Arterial angioplasty to treat hand ischemia in a radial-cephalic fistula. In: Seminars in Dialysis. 2009 ; Vol. 22, No. 5. pp. 561-563.
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