Neurovascular complications of brachial arteriovenous fistula

Fifty-one patients with renal failure underwent construction of arteriovenous fistulas at the University of Utah Medical Center and the Salt Lake Veterans Administration Hospital during the last three years and have been maintained on hemodialysis using these fistulas. Forty-three of the patients had arteriovenous fistulas at the wrist level (radial artery) with several failures, primarily from clotting. Eight patients had fistulas at the elbow level (brachial artery) and in two of these patients neurovascular complications developed which were confined to the forearm and hand in the extremity with the fistula. The neurovascular problems were characterized by pallor, paresthesias, pain, weakness, and muscle atrophy in the forearm and hand. These complications were reversed rapidly by surgical correction of the fistula which restored normal circulation to the extremity.