Percutaneous interventions to maintain or re-establish patent vascular access are common and often necessary for patients on hemodialysis. This case illustrates an extremely rare but potentially devastating complication of one of these procedures: cerebrovascular insult due to paradoxical embolism in the setting of a patent foramen ovale.
ChanKEPfledererTASteeleDJet al.Access survival amongst hemodialysis patients referred for preventive angiography and percutaneous transluminal angioplasty.Clin J Am Soc Nephrol2011;6(11):2669–2680
2.
ShahAAnsariNHamadehZCardiac arrest secondary to bilateral pulmonary emboli following arteriovenous fistula thrombectomy: a case report with review of the literature.Case Rep Nephrol2012;2012:831726
3.
WengFLBernsJSComplications of percutaneous treatment of thrombosed hemodialysis access grafts.Semin Dial200316(3):257–262
4.
BeathardGALitchfieldTPhysician Operators Forum of RMS Lifeline, Inc. Effectiveness and safety of dialysis vascular access procedures performed by interventional nephrologists.Kidney Int2004;66(4):1622–1632
5.
BentaaritBDuvalAMMaravalAet al.Paradoxical embolism following thromboaspiration of an arteriovenous fistula thrombosis: a case report.J Med Case Reports2010;4(1):345
6.
BriefelGRReganFPetronisJDCerebral embolism after mechanical thrombolysis of a clotted hemodialysis access.Am J Kidney Dis1999;34(2):341–343
7.
SantosJPHamadehZAnsariNCerebrovascular accident secondary to paradoxical embolism following arteriovenous graft thrombectomy.Case Rep Nephrol2012;2012183730doi.org/10.1155/2012/183730.
8.
OwensCAYaghmaiBAletichVBenedettiEEcanowJWarnerDFatal paradoxic embolism during percutaneous thrombolysis of a hemodialysis graft.AJR Am J Roentgenol1998;170(3):742–744
9.
MeissnerIWhisnantJPKhandheriaBKet al.Prevalence of potential risk factors for stroke assessed by transesophageal echocardiography and carotid ultrasonography: the SPARC study. Stroke Prevention: Assessment of Risk in a Community.Mayo Clin Proc1999;74(9):862–869
10.
WuSAhmadIQayyumSWickySKalvaSPParadoxical embolism after declotting of hemodialysis fistulae/grafts in patients with patent foramen ovale.Clin J Am Soc Nephrol2011;6(6):1333–1336
