Postcatheterization radial arteriovenous fistula: balloon-assisted direct percutaneous embolization with N-butyl cyanoacrylate and 50 % glucose solution in two sessions

Jpn J Radiol. 2013 Jul;31(7):505-10. doi: 10.1007/s11604-013-0206-8. Epub 2013 Apr 23.

Abstract

We report an iatrogenic radial arteriovenous fistula (AVF) in a 74-year-old woman presenting with right radial bruit and pain 8 months after sheath removal for cardiac catheterization. She refused surgical ligation and underwent balloon-assisted direct percutaneous embolization of the draining vein with N-butyl cyanoacrylate (NBCA). Another draining vein that developed immediately after the procedure was conservatively treated with 1 month of continuous band compression. However, its diameter gradually increased and, as the patient desired complete remission, an additional procedure was conducted 2 months after initial treatment. A second balloon-assisted direct percutaneous embolization was performed using a 50 % glucose solution, which resulted in complete resolution. Although surgical repair is considered to be the standard treatment, in patients where surgery is not indicated, endovascular intervention-although complicated-may be an alternative treatment modality.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Arteriovenous Fistula / diagnosis*
  • Arteriovenous Fistula / etiology*
  • Arteriovenous Fistula / therapy*
  • Balloon Occlusion / methods*
  • Cardiac Catheterization / adverse effects*
  • Device Removal / adverse effects
  • Diagnostic Imaging*
  • Enbucrilate / therapeutic use
  • Female
  • Glucose / therapeutic use
  • Humans
  • Iatrogenic Disease
  • Radial Artery*

Substances

  • Enbucrilate
  • Glucose