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Angioplasty and Stenting of a Jugular-Carotid Fistula Resulting from the Inadvertent Placement of a Hemodialysis Catheter: Case Report and Review of Literature


Address correspondence to: Hugo Cuellar, M.D., Department of Neurosurgery, LSUHSC-Shreveport, 1501 Kings Highway, Shreveport, LA 71103, Tel.: 318-675-8921, Fax: 318-675-6867, or e-mail:


Hemodialysis catheterization through the right internal jugular vein (IJV) is widely used for mid- to long-term hemodialysis for patients with renal failure. The purpose of this report is to address a serious complication in conjunction with this procedure. This is a case report of an iatrogenic jugular-carotid fistula (JCF) and a method for rectifying such a vascular conundrum, using endovascular techniques. We describe the technique used to achieve closure of the fistula as well a review of the literature. An 82-year-old woman with history of congestive heart failure, chronic renal failure, and diabetes mellitus developed an iatrogenic arteriovenous fistula, following an attempt of canalizing the right IJV. The patient was treated using three different stents, which achieved closure of the fistula. Venous catheter misplacement into an artery is a serious complication. Early endovascular treatment should be considered for a JCF.