Lower limb gigantism, lymphedema, and painful varicosities following a thigh vascular access graft.
Identifieur interne : 001709 ( PubMed/Corpus ); précédent : 001708; suivant : 001710Lower limb gigantism, lymphedema, and painful varicosities following a thigh vascular access graft.
Auteurs : Michael Thompson ; Umasankar Mathuram Thiyagarajan ; Jacob A. AkohSource :
- Hemodialysis international. International Symposium on Home Hemodialysis [ 1542-4758 ] ; 2014.
English descriptors
- KwdEn :
- MESH :
- adverse effects : Arteriovenous Shunt, Surgical.
- blood : Lymphedema.
- blood supply : Leg.
- etiology : Gigantism, Lymphedema, Varicose Veins.
- methods : Arteriovenous Shunt, Surgical.
- pathology : Lymphedema.
- Female, Humans, Middle Aged, Treatment Outcome.
Abstract
Prosthetic arteriovenous grafts (AVGs) are associated with greater morbidity than autogenous arteriovenous fistulas (AVFs), but their use is indicated when AVF formation is not possible. This report adds to the literature a case of lower limb gigantism, painful varicosities, and lymphedema following long-term use of AVG in the upper thigh. The patient's past medical history included renal transplantation on the same side well before the AVG was inserted and right leg deep vein thrombosis. Suspicion of AVG thrombosis was excluded by Doppler ultrasound, which demonstrated an access flow of 1700 mL/min. A computed tomography (CT) scan of the abdomen and pelvis did not identify the cause of her symptoms. Whereas functional incompetence of the iliac vein valve might be responsible for the varicosities, the extent of hypertrophy in this case raises the suspicion of lymphatic blockage possibly secondary to groin dissection undertaken at the time of graft insertion, in addition to the previous dissection at the time of transplantation. This case highlights the need for minimal groin dissection during AVG insertion, particularly in patients with a history of previous abdominopelvic surgery.
DOI: 10.1111/hdi.12144
PubMed: 24467313
Links to Exploration step
pubmed:24467313Le document en format XML
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<author><name sortKey="Thompson, Michael" sort="Thompson, Michael" uniqKey="Thompson M" first="Michael" last="Thompson">Michael Thompson</name>
<affiliation><nlm:affiliation>South West Transplant Centre, Derriford Hospital, Plymouth Hospitals NHS Trust, Plymouth, UK.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Mathuram Thiyagarajan, Umasankar" sort="Mathuram Thiyagarajan, Umasankar" uniqKey="Mathuram Thiyagarajan U" first="Umasankar" last="Mathuram Thiyagarajan">Umasankar Mathuram Thiyagarajan</name>
</author>
<author><name sortKey="Akoh, Jacob A" sort="Akoh, Jacob A" uniqKey="Akoh J" first="Jacob A" last="Akoh">Jacob A. Akoh</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Lower limb gigantism, lymphedema, and painful varicosities following a thigh vascular access graft.</title>
<author><name sortKey="Thompson, Michael" sort="Thompson, Michael" uniqKey="Thompson M" first="Michael" last="Thompson">Michael Thompson</name>
<affiliation><nlm:affiliation>South West Transplant Centre, Derriford Hospital, Plymouth Hospitals NHS Trust, Plymouth, UK.</nlm:affiliation>
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<author><name sortKey="Mathuram Thiyagarajan, Umasankar" sort="Mathuram Thiyagarajan, Umasankar" uniqKey="Mathuram Thiyagarajan U" first="Umasankar" last="Mathuram Thiyagarajan">Umasankar Mathuram Thiyagarajan</name>
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<author><name sortKey="Akoh, Jacob A" sort="Akoh, Jacob A" uniqKey="Akoh J" first="Jacob A" last="Akoh">Jacob A. Akoh</name>
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<series><title level="j">Hemodialysis international. International Symposium on Home Hemodialysis</title>
<idno type="eISSN">1542-4758</idno>
<imprint><date when="2014" type="published">2014</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arteriovenous Shunt, Surgical (adverse effects)</term>
<term>Arteriovenous Shunt, Surgical (methods)</term>
<term>Female</term>
<term>Gigantism (etiology)</term>
<term>Humans</term>
<term>Leg (blood supply)</term>
<term>Lymphedema (blood)</term>
<term>Lymphedema (etiology)</term>
<term>Lymphedema (pathology)</term>
<term>Middle Aged</term>
<term>Treatment Outcome</term>
<term>Varicose Veins (etiology)</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Arteriovenous Shunt, Surgical</term>
</keywords>
<keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="blood supply" xml:lang="en"><term>Leg</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Gigantism</term>
<term>Lymphedema</term>
<term>Varicose Veins</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Arteriovenous Shunt, Surgical</term>
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<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Lymphedema</term>
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<keywords scheme="MESH" xml:lang="en"><term>Female</term>
<term>Humans</term>
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<front><div type="abstract" xml:lang="en">Prosthetic arteriovenous grafts (AVGs) are associated with greater morbidity than autogenous arteriovenous fistulas (AVFs), but their use is indicated when AVF formation is not possible. This report adds to the literature a case of lower limb gigantism, painful varicosities, and lymphedema following long-term use of AVG in the upper thigh. The patient's past medical history included renal transplantation on the same side well before the AVG was inserted and right leg deep vein thrombosis. Suspicion of AVG thrombosis was excluded by Doppler ultrasound, which demonstrated an access flow of 1700 mL/min. A computed tomography (CT) scan of the abdomen and pelvis did not identify the cause of her symptoms. Whereas functional incompetence of the iliac vein valve might be responsible for the varicosities, the extent of hypertrophy in this case raises the suspicion of lymphatic blockage possibly secondary to groin dissection undertaken at the time of graft insertion, in addition to the previous dissection at the time of transplantation. This case highlights the need for minimal groin dissection during AVG insertion, particularly in patients with a history of previous abdominopelvic surgery.</div>
</front>
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<DateCompleted><Year>2015</Year>
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<DateRevised><Year>2014</Year>
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<Title>Hemodialysis international. International Symposium on Home Hemodialysis</Title>
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<ArticleTitle>Lower limb gigantism, lymphedema, and painful varicosities following a thigh vascular access graft.</ArticleTitle>
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<Abstract><AbstractText>Prosthetic arteriovenous grafts (AVGs) are associated with greater morbidity than autogenous arteriovenous fistulas (AVFs), but their use is indicated when AVF formation is not possible. This report adds to the literature a case of lower limb gigantism, painful varicosities, and lymphedema following long-term use of AVG in the upper thigh. The patient's past medical history included renal transplantation on the same side well before the AVG was inserted and right leg deep vein thrombosis. Suspicion of AVG thrombosis was excluded by Doppler ultrasound, which demonstrated an access flow of 1700 mL/min. A computed tomography (CT) scan of the abdomen and pelvis did not identify the cause of her symptoms. Whereas functional incompetence of the iliac vein valve might be responsible for the varicosities, the extent of hypertrophy in this case raises the suspicion of lymphatic blockage possibly secondary to groin dissection undertaken at the time of graft insertion, in addition to the previous dissection at the time of transplantation. This case highlights the need for minimal groin dissection during AVG insertion, particularly in patients with a history of previous abdominopelvic surgery.</AbstractText>
<CopyrightInformation>© 2014 International Society for Hemodialysis.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Thompson</LastName>
<ForeName>Michael</ForeName>
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<AffiliationInfo><Affiliation>South West Transplant Centre, Derriford Hospital, Plymouth Hospitals NHS Trust, Plymouth, UK.</Affiliation>
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<Author ValidYN="Y"><LastName>Mathuram Thiyagarajan</LastName>
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<Author ValidYN="Y"><LastName>Akoh</LastName>
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<Language>eng</Language>
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<ArticleDate DateType="Electronic"><Year>2014</Year>
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<MedlineJournalInfo><Country>Canada</Country>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D001166" MajorTopicYN="N">Arteriovenous Shunt, Surgical</DescriptorName>
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<QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName>
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<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
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<MeshHeading><DescriptorName UI="D005877" MajorTopicYN="N">Gigantism</DescriptorName>
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<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
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<MeshHeading><DescriptorName UI="D007866" MajorTopicYN="N">Leg</DescriptorName>
<QualifierName UI="Q000098" MajorTopicYN="Y">blood supply</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName>
<QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName>
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<QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName>
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<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
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<MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014648" MajorTopicYN="N">Varicose Veins</DescriptorName>
<QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Arteriovenous graft</Keyword>
<Keyword MajorTopicYN="N">limb gigantism</Keyword>
<Keyword MajorTopicYN="N">lymphedema</Keyword>
<Keyword MajorTopicYN="N">varicosities</Keyword>
</KeywordList>
</MedlineCitation>
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