Arteriovenous fistula stenosis
End-stage renal disease on dialysis. Inadequate dialysis. Low urea clearance ?stenosis.
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The venous limb of the left radiocephalic fistula was accessed using a 20g cannula.
Angiographic runs demonstrate aneurysmal dilatation of the distal venous limb, with two foci of narrowing up to 3.5mm within the region of the puncture site. No other narrowing proximally of the cephalic or basilic vein to the SVC.
The anastomosis with the radial artery appears patent with no stenosis.
Two foci of moderate stenosis of the venous limb of the radiocephalic fistula at the level of the puncture site, which would be amenable to fistuloplasty.
Forceps are placed over the venous limb to achieve occlusion in order to assess the arterio-venous anastomosis.
The patient proceeded to balloon fistuloplasty of the stenoses.