28 April 2014
: Case report
Fatal pulmonary embolism after hemodialysis vascular access declotting
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Rare disease
Seyed Ali SadjadiABCEFG, Maryam Sharif-HassanabadiBFDOI: 10.12659/AJCR.890364
Am J Case Rep 2014; 15:172-175
Abstract
BACKGROUND: Vascular access is the lifeline of hemodialysis patients and access problems are a major source of morbidity and mortality for these patients. Access stenosis and thrombosis are common problems in dialysis patients and require prompt intervention. Every year thousands of these procedures are performed in the United States by radiologists, surgeons, and interventional nephrologists.
CASE REPORT: A 59-year-old man on chronic hemodialysis with multiple medical problems, including diabetes mellitus, hypertension, chronic obstructive lung disease, hepatitis C infection, and end-stage renal disease, who had clotted his access several times before ,presented with another episode of access clotting. He underwent declotting successfully but upon angioplasty of the access feeding artery, he developed massive pulmonary embolism and died. Postmortem examination showed multiple pulmonary emboli, including cholesterol crystals in his lungs
CONCLUSIONS: Hemodialysis access declotting and angioplasty are usually benign and do not cause a major problem. However, occasionally they become complicated. In difficult cases and in people with multiple comorbidities, it is preferable to forego the existing dialysis access and either plan for creation of a new vascular access or place a central vein catheter.
Keywords: Hypercholesterolemia, Blood Coagulation, Renal Dialysis, Pulmonary Embolism
In Press
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.948268
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.948283
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.947725
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.947694
Most Viewed Current Articles
21 Jun 2024 : Case report
102,058
DOI :10.12659/AJCR.944371
Am J Case Rep 2024; 25:e944371
07 Mar 2024 : Case report
54,550
DOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
20 Nov 2023 : Case report
38,308
DOI :10.12659/AJCR.941424
Am J Case Rep 2023; 24:e941424
07 Jul 2023 : Case report
26,047
DOI :10.12659/AJCR.940200
Am J Case Rep 2023; 24:e940200