PMC10233604_01
Grayscale ultrasound (US) at the left antecubital fossa in transverse and
longitudinal views reveals a 1.6 x 0.5 x 0.3 cm serpentine, avascular,
hypoechoic collection (yellow calipers) deep to the cephalic vein, which
represents a small hematoma.
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PMC10233604_01_10.1177_11795476231177793-fig1.jpg
fig1-11795476231177793
Given concerns for possible underlying pseudoaneurysm, aneurysm, hematoma or fistula, a venous ultrasound performed in the radiology department, identified a 1.7 x 0.3 x 0.5 cm hematoma in the antecubital fossa posterior to the cephalic vein (Figure 1), as well as pulsatile flow and an arterialized waveform in the left cephalic vein (Figure 2).
Longitudinal Color and spectral Doppler US at the left antecubital fossa
reveals a pulsatile, arterialized waveform in the cephalic vein, concerning
for an arteriovenous fistula.
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PMC10233604_01_10.1177_11795476231177793-fig2.jpg
fig2-11795476231177793
Given concerns for possible underlying pseudoaneurysm, aneurysm, hematoma or fistula, a venous ultrasound performed in the radiology department, identified a 1.7 x 0.3 x 0.5 cm hematoma in the antecubital fossa posterior to the cephalic vein (Figure 1), as well as pulsatile flow and an arterialized waveform in the left cephalic vein (Figure 2).
Transverse Color Doppler US the left antecubital fossa reveals a small
tortuous arterial branch (white arrow) joining the cephalic vein (yellow
arrow) confirming arteriovenous fistula as cause for the pulsatile waveform
in Figure 2.
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PMC10233604_01_10.1177_11795476231177793-fig3.jpg
fig3-11795476231177793
An abnormal connection between a small arterial branch and the cephalic vein was visualized, consistent with an arteriovenous fistula (Figures 3 and 4).
Longitudinal microvascular flow US at the left antecubital fossa confirms the
abnormal connection between a small arterial branch and the cephalic vein
(white arrow). This technique improves visualization of blood flow in small
structures such as superficial arterial and venous branches.
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PMC10233604_01_10.1177_11795476231177793-fig4.jpg
fig4-11795476231177793
An abnormal connection between a small arterial branch and the cephalic vein was visualized, consistent with an arteriovenous fistula (Figures 3 and 4).