Arterial injuries following diagnostic, therapeutic, and accidental arterial cannulation in haemodialysis patients

BACKGROUND: Incidence of iatrogenic arterial lesions is currently increasing and patients undergoing dialysis represent a group at high risk since they require repeated cannulation of the vascular access and intermittent heparinization during maintenance haemodialysis. CLINICAL REPORTS: Between 1992 and 1995 we treated four vascular lesions (two pseudoaneurysms and two arteriovenous fistulae) with surgery in three patients undergoing dialysis at our centre. No postoperative morbidity and mortality was observed; in all cases surgery was effective. CONCLUSIONS: Although conservative treatment (US guided compression) of arterial lesions shows promising results, in patients undergoing dialysis combined with heparinization it seems less suitable. In these patients, early detection of post-cannulation pseudoaneurysms or arteriovenous fistulae allows surgical treatment, with low morbidity rate and satisfactory long-term outcome.