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Thrombosed renal dialysis fistula

Case contributed by Ali Abougazia
Diagnosis probable

Presentation

Known patient with chronic renal failure on haemodialysis. The AV fistula was not functioning anymore.

Patient Data

Age: 60 years
ultrasound

The haemodialysis arteriovenous fistula in the left arm between left brachial artery and left cephalic vein (end to side) shows two saccular dilatations in its midcourse which are distended by an echogenic, partially calcified subtotal thrombus extending into most of the shunt's course with lost compressibility and remaining marginal flow. It is seen patent in its distal most part, before joining left brachial artery, and its proximal most part, before joining subclavian vein. 

The brachial, radial and ulnar arteries show return of the normal triphasic waveform pattern, consistent with the shunt occlusion.

Case Discussion

Haemodialysis arteriovenous fistula occlusion due to chronic thrombosis.

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