A 69-year-old Native American female with a past medical history of end-stage renal disease presented to our rural outpatient dialysis access center. One and a half years prior, the patient's arteriovenous fistula was banded due to venous steal syndrome and now demonstrated an abnormal bruit with decreased blood flow during dialysis. On arteriogram, she was found to have a 90% narrowing of her previously banded cephalic vein along with stenosis of the arterial anastomosis and subclavian vein. Balloon angioplasty was performed on the subclavian vein stenosis, and the banded cephalic vein was ruptured. However, the arterial anastomosis stenosis was left untreated due to the patient's previous venous steal syndrome.
Keywords: angiography; arteriovenous (av) fistula; chronic kidney disease (ckd); end stage renal disease (esrd); hemodialysis; kidney transplant; rural medicine; venous angioplasty.
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