Ultrasound of a Failed Proximal Radial Artery-Cephalic Vein Arteriovenous Fistula

The most common cause of vascular access failure is thrombosis. In AVF thrombotic occlusion oftenoccur early due to inadequate flow resulting from small lumen of vessels or failure to dilate. Once AVFis matured thrombosis is rare. We report a unique case of a matured AVF, which was functioning normally, that failed after a successful dialysis. The cause of the failure was not due to thrombosis or venous hypertension but due to a large hematoma formed under the cephalic vein which then pushed the draining vein to close. The hematoma was likely caused by the perforation of the vein at both ends during cannulation.

Keywords: AVF, hemodialysis, radial artery, cephalic vein, ultrasound.