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Hemodiyaliz Sırasında Damar Girişimi Ekstremite Kaybına Neden Olabilir mi?

Can Vascular Access During Hemodialysis Cause Extremity Loss?

Journal Name:

Publication Year:

DOI: 
10.5262/tndt.2013.1002.14
Abstract (2. Language): 
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..
Abstract (Original Language): 
Hemodiyaliz hastalarında vasküler girişim sırasında her zaman komplikasyon gelişme olasılığı mevcuttur. Hatalı arteryal enjeksiyona bağlı psödoanevrizma gelişimi, ekstremite kaybına kadar ulaşan ciddi klinik sonuçlara yol açabilen, çok önemli komplikasyonlardan biridir. Biz 78 yaşında renal yetmezlik sebebiyle düzenli diyalize giren bir hastayı tanımladık. Hastada brakiyal arter anevrizmasının neden olduğu diyaliz sonrası ani başlayan ciddi sol kol ağrısı, hızlı ilerleyen, siyanoz ve kompartman sendromu mevcuttu. Acil cerrahi prosedür uygulandı. Psödoanevrizma başarı ile onarılarak, kolun dolaşımı tekrar sağlandı ve kompartman sendromu nedeniyle sol kola fasyotomi uygulandı. İkinci seansta nekrotik lezyonlara debritman ve dermal greft uygulandı. Tedaviyi takip eden 2 ay içerisinde hasta tam iyileşme ile taburcu edildi. Bu vakada hemodiyaliz sırasındaki vasküler erişimlerin ekstremite kaybına varabilen bazı komplikasyonları olduğunu vurgulamak istedik.
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