Ischemic neuropathy is most common in diabetic patients with severe forms of peripheral arterial disease, especially when the brachial artery is used for creation of vascular access. It is manifested by weak arms, in the immediate preoperative period, severe pain, and paresthesia. Neurological examination shows weakness in distal muscle groups in the area of sensory innervation by a defective median nerve. The frequency of such complications varies between 1 and 10%. The syndrome develops quickly (typically within hours) of AVF creation (Andary MTand Mahal BS 2010). The etiology for this complication is multifactorial and includes ischemia, venous hypertension and local compression (Rogers NM & Lawton PD, 2004).
Ischemic neuropathy is most common in diabetic patients with severe forms of peripheral arterial disease, especially when the brachial artery is used for creation of vascular access. It is manifested by weak arms, in the immediate preoperative period, severe pain, and paresthesia. Neurological examination shows weakness in distal muscle groups in the area of sensory innervation by a defective median nerve. The frequency of such complications varies between 1 and 10%. The syndrome develops quickly (typically within hours) of AVF creation (Andary MTand Mahal BS 2010). The etiology for this complication is multifactorial and includes ischemia, venous hypertension and local compression (Rogers NM & Lawton PD, 2004).