Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.008618
Jornal Vascular Brasileiro
Case Report

Fístula arteriovenosa pós-cateterismo radial com repercussões cardiopulmonares

Arteriovenous fistula after radial catheterization with cardiopulmonary repercussions

Alexandre Faraco de Oliveira; Alexandre David Ribeiro; Marcio Costa Silveira Ávila

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Resumo

Resumo: O presente artigo relata o caso de um paciente coronariopata de 86 anos submetido a cateterismo cardíaco via acesso radial à esquerda. Cerca de 16 meses após o procedimento, manifestou dispneia sem relação com esforço, associada a hipóxia noturna. Apresentava frêmito à palpação do punho esquerdo e foi diagnosticado com fístula arteriovenosa radiocefálica no punho esquerdo. Ao duplex scan apresentava alteração de padrão de onda e aumento da velocidade diastólica compatível com fístula arteriovenosa. Foi submetido a correção cirúrgica da fístula, apresentando melhora clínica e laboratorial após o procedimento. O acesso radial para cateterismo cardíaco tem sido cada vez mais utilizado, principalmente por causar complicações menos frequentes e menos deletérias em comparação ao acesso femoral. Entretanto, complicações como fístula arteriovenosa ocorrem e podem ser especialmente prejudiciais em pacientes octogenários.

Palavras-chave

fístula arteriovenosa, cateterismo cardíaco, intervenção coronária percutânea, dispneia

Abstract

Abstract: This article describes the case of an 86-year-old coronary disease patient who underwent cardiac catheterization via a left radial access. Around 16 months after the procedure, he presented with dyspnea, unrelated to effort, but associated with nocturnal hypoxia. There was a palpable thrill in the left wrist and he was diagnosed with a radiocephalic arteriovenous fistula in the left wrist. A duplex scan revealed an abnormal wave pattern and increased diastolic velocity compatible with arteriovenous fistula. The fistula was repaired surgically and the patient exhibited improvement in clinical and laboratory parameters after the procedure. Radial access is increasingly being used for cardiac catheterization, primarily because it is associated with fewer and less harmful complications than femoral access. However, complications such as arteriovenous fistula occur and can be particularly harmful in octogenarian patients.
 

Keywords

arteriovenous fistula, cardiac catheterization, percutaneous coronary intervention, dyspnea

References

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