Thread by @aishaikh

💥 Another interesting clinical case of “Dizziness following angioplasty of the right forearm AVF in a hemodialysis patient” - by @AdinaVoiculescu @ASDINNews @dialysisaccess1

⚡️Live Clinical Case #ASDIN2021
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⚡️81 year old hemodialysis patient with a right radial cephalic AVF (created recently) and a left brachial cephalic AVF created a year ago and abandoned due to low AVF flow (but the left AVF was not ligated)👇🏽
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⚡️Patient presented with signs of poor inflow in the right radial cephalic AVF and a Fistulogram confirmed inflow stenosis👇🏽
-AVF angioplasty was performed and improvement in AVF flow was documented following inflow stenosis angioplasty👇🏽
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⚡️But the day after AVF angioplasty the patient developed severe dizziness

-Initial assessment did not reveal a cause for dizziness👇🏽
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⚡️But the vertebral artery Doppler showed flow reversal👇🏽
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⚡️What would you do next?👇🏽
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⚡️The patient’s left brachial cephalic AVF was ligated and the dizziness resolved
-What was the cause of the underlying dizziness in this case?
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⚡️Here is a recap of what has happened so far👇🏽
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⚡️The dizziness in this case was caused by Subclavian Steal Syndrome which caused reversal of flow in the vertebral artery

⚡️It can be seen in patients with bilateral AV accesses (as seen in this case) or with an AV access with high flow rate.
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