Patient 3

This patient has a 5 year old left brachio-basilic AVF. You notice that this patient’s left arm is larger than the right arm.

The patient says, “For a while now, my arm seems to be  getting bigger and so is the fistula.”

Note that he has no pain or redness in the arm.  He has no facial or neck swelling.

 

What do you know notice about the fistula on closer inspection?

Watch this video to take a closer look at his fistula.

Because of the findings of hyperpulsatility, enlarging aneurysms/ PSAs and arm hypertrophy, you are worried about venous outflow stenosis

Watch this video and answer questions about the physical exam.

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