Can vascular access during hemodialysis cause extremity loss?

Abstract

There is always the possibility of complications of vascular access in patients with hemodialysis. The pseudoaneurysm related with accidental arterial puncture is one of the most important complications in patients with hemodialysis and it can cause severe clinic manifestations that may go all the way to limb loss. We describe a 78-year-old woman undergoing regular dialysis treatment with renal failure. The patient had severe left arm pain starting suddenly after hemodialysis, with rapidly progressing cyanosis, and compartment syndrome caused by brachial artery pseudoaneurysm. Urgent surgical procedure was performed. The pseudoaneurysm was successfully repaired, left arm arterial circulation reestablished, and fasciotomy performed on the left arm for compartment syndrome. In the second session, debridement was performed and dermal graft applied to the necrotic lesions. The patient was discharged with full recovery within 2 months following the treatment. In this case, we emphasize that vascular access during hemodialysis has some complications that can even cause extremity loss.