Femoral arteriovenous fistula: a complication of temporary hemodialysis catheter placement

The femoral vein is increasingly being used as a temporary route for dual-lumen hemodialysis catheter placement because it is thought to be safer than the internal jugular or subclavian vein sites. However, several factors preclude the wider use of indwelling femoral catheters for hemodialysis, including interference with ambulation and concern over bleeding, infection, and deep thrombosis. Herein we describe a case of right superficial femoral arteriovenous fistula as a complication of the insertion of a dual-lumen hemodialysis catheter into the right femoral vein. The arteriovenous fistula was successfully managed with surgical vascular repair. From this experience, we emphasize that it is important for physicians and nursing staff treating patients with indwelling central catheters to exercise vigilance to allow early detection and treatment of these potentially serious, albeit rare, complications.