Arthroscopically assisted reconstruction of the anterior cruciate ligament (LCA) is generally a safe and effective procedure with a low rate of vascular complications. We report on a case of a 33-year-old woman with a...Arthroscopically assisted reconstruction of the anterior cruciate ligament (LCA) is generally a safe and effective procedure with a low rate of vascular complications. We report on a case of a 33-year-old woman with a combined arteriovenous fistula (AVF) and venous popliteal aneurysm that developed 6 months after arthroscopic anterior cruciate ligament reconstruction. At clinical exam the patient presented with left popliteal and calf pain, a tender pulsatile mass posterior to her left knee, popliteal bruit and a thrill at the popliteal fossa. CT scan showed an AVF arising from the left popliteal artery. An aneurysm was seen to fill at the same time as the popliteal vein. Findings at open surgical revision included AVF between the tibioperoneal trunk and the popliteal vein and a venous popliteal aneurysm at the level of the arteriovenous communication. The aneurysm and fistula were repaired. The patient had an uneventful follow up with complete recovery. We also report an endovascular treatment of a iatrogenic arterio-venous fistula.展开更多
Patients on chronic hemodialysis (HD) required efficient arterio-venous access. Different types of vascular access are commonly used, such as native arteriovenous (AV) fistula, prosthetic AV graft, central venous cath...Patients on chronic hemodialysis (HD) required efficient arterio-venous access. Different types of vascular access are commonly used, such as native arteriovenous (AV) fistula, prosthetic AV graft, central venous catheter, or temporary and tunnelled cuffed catheters. Vascular access—related morbidity remains the major issue for patients requiring long-term therapy. Vascular access infection constitutes the most challenging and life-threatening complication of vascular access and causes significant morbidity, loss of access and mortality. Vascular access infection is defined as local signs at the vascular access site or a positive blood culture with no know source other than the vascular access. The critical issue in the management of AV graft infection is the need to remove the infection and to maintain HD access with reduced morbidity. The diagnosis of infected AV graft is not always easy, especially with low-grade infection or atypical presentation. Fluorodeoxyglucose positron emission tomography (FDG-PET) is an imaging method that uses a radioactively labelled tracer (18 fluorodeoxy glucose) which is taken up by tissue with high metabolic activity, such as neoplastic and inflammatory lesions. FDG-PET has been proposed to visualise localisation of infection in patients with suspected prosthetic graft infection. We report a case of methicilin resistant staphylococcus aureus (MRSA) hemodialysis access infection without local inflammatory signs diagnosed on the PET-CT.展开更多
文摘Arthroscopically assisted reconstruction of the anterior cruciate ligament (LCA) is generally a safe and effective procedure with a low rate of vascular complications. We report on a case of a 33-year-old woman with a combined arteriovenous fistula (AVF) and venous popliteal aneurysm that developed 6 months after arthroscopic anterior cruciate ligament reconstruction. At clinical exam the patient presented with left popliteal and calf pain, a tender pulsatile mass posterior to her left knee, popliteal bruit and a thrill at the popliteal fossa. CT scan showed an AVF arising from the left popliteal artery. An aneurysm was seen to fill at the same time as the popliteal vein. Findings at open surgical revision included AVF between the tibioperoneal trunk and the popliteal vein and a venous popliteal aneurysm at the level of the arteriovenous communication. The aneurysm and fistula were repaired. The patient had an uneventful follow up with complete recovery. We also report an endovascular treatment of a iatrogenic arterio-venous fistula.
文摘Patients on chronic hemodialysis (HD) required efficient arterio-venous access. Different types of vascular access are commonly used, such as native arteriovenous (AV) fistula, prosthetic AV graft, central venous catheter, or temporary and tunnelled cuffed catheters. Vascular access—related morbidity remains the major issue for patients requiring long-term therapy. Vascular access infection constitutes the most challenging and life-threatening complication of vascular access and causes significant morbidity, loss of access and mortality. Vascular access infection is defined as local signs at the vascular access site or a positive blood culture with no know source other than the vascular access. The critical issue in the management of AV graft infection is the need to remove the infection and to maintain HD access with reduced morbidity. The diagnosis of infected AV graft is not always easy, especially with low-grade infection or atypical presentation. Fluorodeoxyglucose positron emission tomography (FDG-PET) is an imaging method that uses a radioactively labelled tracer (18 fluorodeoxy glucose) which is taken up by tissue with high metabolic activity, such as neoplastic and inflammatory lesions. FDG-PET has been proposed to visualise localisation of infection in patients with suspected prosthetic graft infection. We report a case of methicilin resistant staphylococcus aureus (MRSA) hemodialysis access infection without local inflammatory signs diagnosed on the PET-CT.
