An iliac arteriovenous fistula associated with leg swelling 2 years after the removal of a hemodialysis catheter: A case report

Rationale:Temporary central venous catheters are commonly used for patients who require emergency hemodialysis. In rare instances, this procedure can result in a very serious complication known as arteriovenous fistula (AVF). Although some cases of femoral arteriovenous fistula have been reported previously in the literature; however, the incidence of iliac AVF precipitated by a hemodialysis catheter is exceedingly uncommon. The purpose of this study is to report a case in which a hemodialysis catheter caused a femoral arteriovenous fistula and to describe the successful treatment, thereby providing a reference for the diagnosis and treatment of such conditions in the future.Patient concerns:Herein, we report the case of a patient with diabetes and end-stage kidney disease (ESKD) who presented with an iliac arteriovenous fistula as a complication of hemodialysis catheter insertion into the right femoral vein. Two years after hemodialysis catheter removal, the patient was admitted to our institution with swelling of the right lower limb and calf pain.Diagnosis:The patient was subsequently diagnosed with an iliac arteriovenous fistula by computed tomography angiography and angiography.Interventions:The patient was transferred to the Vascular Surgery Department for surgical treatment.Outcomes:The patient's leg swelling improved after surgery. After 1 year of follow-up, there was no occurrence of swelling in the patient's right leg.Lessons:If the patient has a history of femoral venous catheter placement and develops limb swelling, in addition to considering the presence of a femoral arteriovenous fistula, it is important to consider the possibility of an iliac AVF. Iliac AVF are rare disorders. The primary goal for treatment of IAVF is to relieve associated symptoms. Based on the results of this study, the endovascular approach is safe and effective for the treatment of iliac AVF. Iliac AVFs are rare disorders. The primary goal of treatment for iliac AVFs is to relieve associated symptoms. Based on the results of this study, the endovascular approach is safe and effective in the treatment of iliac AVFs.