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 language | English |
|---|---|
| Pages (from-to) | 561-563 |
| Number of pages | 3 |
| Journal | Seminars in Dialysis |
| Volume | 22 |
| Issue number | 5 |
| DOIs | |
| State | Published - Sep 1 2009 |
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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 journal › Article
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TY - JOUR
T1 - Arterial angioplasty to treat hand ischemia in a radial-cephalic fistula
AU - Samaha, Antoine
AU - Salman, Loay
AU - Asif, Arif
PY - 2009/9/1
Y1 - 2009/9/1
N2 - 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.
AB - 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.
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U2 - 10.1111/j.1525-139X.2009.00625.x
DO - 10.1111/j.1525-139X.2009.00625.x
M3 - Article
VL - 22
SP - 561
EP - 563
JO - Seminars in Dialysis
JF - Seminars in Dialysis
SN - 0894-0959
IS - 5
ER -