Arteriovenous fistula complication following MRI

BMJ Case Rep. 2012 Aug 27:2012:bcr0320126103. doi: 10.1136/bcr-03-2012-6103.

Abstract

Health professionals should be aware of medical procedures that cause vascular access complications. This case describes a haemodialysis patient who experienced pain, swelling and bruising over a radiocephalic fistula following MRI. Exactly the same signs and symptoms were evident following a second scan performed 3 months later. Plausible explanations include a radio frequency-induced electrical current being formed at the arteriovenous fistula, or varying gradients of the MRI sequence stimulating peripheral nerves, leading to a site of increased tissue stimulation. Of note, a juxta-anastomotic venous stenosis was confirmed by fistulogram 4 days after the second scan, although whether this access failure was due to the MRI scan per se could not be ascertained. Nevertheless, these previously undocumented observations suggest that careful patient and fistula monitoring is required when completing MRI scans in those with an arteriovenous fistula.

Publication types

  • Case Reports

MeSH terms

  • Arm / blood supply
  • Arteriovenous Shunt, Surgical*
  • Blood Flow Velocity / physiology
  • Constriction, Pathologic / diagnosis
  • Constriction, Pathologic / etiology
  • Diabetes Mellitus, Type 2 / complications
  • Diabetic Nephropathies / surgery
  • Follow-Up Studies
  • Graft Occlusion, Vascular / diagnosis
  • Graft Occlusion, Vascular / etiology*
  • Humans
  • Magnetic Resonance Imaging / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology*
  • Recurrence
  • Renal Dialysis*