Mitsutoshi Shindo , MD a , Susumu Ookawara , MD, PhD a , * , Lucie Kovarova , MuDr b , Junki Morino , MD a , Saori Minato , MD a , Kiyonori Ito , MD, PhD a , Jan Malik , MUDr, CSc b , Yoshiyuki Morishita , MD, PhD a
03 July 2020
A 79-year-old woman who was on chronic hemodialysis due to diabetic nephropathy and had previously undergo surgery for radiocephalic arteriovenous fistula (AVF) in her right wrist needed percutaneous transluminal angioplasty (PTA) for stenosis at the juxta-anastomotic access site. After successful PTA, the systemic blood pressure decreased from 144/93 mm Hg to 117/67 mm Hg in response to the increase in AVF blood flow. Furthermore, the regional oxygen saturation (rSO 2) value in her dorsal hand decreased from 67.9% to 64.9% and, simultaneously, the cerebral rSO 2 decreased from 63.6% to 60.1%. Our experience indicates that the PTA procedure may affect the rapid deterioration of systemic oxygenation, including that in the hand and brain, in association with the increase in the AVF blood flow and change in systemic circulation.