[Femoral arteriovenous fistula: a late uncommon complication of central venous catheterization]. / Fistola artero-venosa femorale: rara complicanza tardiva del posizionamento di un catetere venoso centrale per emodialisi.

A 77-year-old woman was admitted due to AV graft thrombosis; given the technical impossibility of performing other native AV fistulas, we chose to insert a tunnelled central venous catheter. Considering the vascular history of the patient, the central venous catheter could not be placed into the internal jugular vein; it was therefore put into the left femoral vein. Following a 3-month-period of the catheter working properly, the patient was hospitalized due to sudden acute pain in the left thigh. In a few days the patient developed an important haematoma with serious anemization in the left lower limb. Ultrasonography showed the presence of a fistula between the left common femoral artery and the femoral vein, leading to the subsequent successful positioning of a stent into the common femoral artery through right trans-femoral access. Angiography examination showed the femoral vein patency along the proximal stretch with respect to the function of the tunnelled venous catheter.

[Physical exercise during hemodialysis session: effect on quality of life]. / Contributo dell'esercizio fisico in corso di emodialisi sulla qualità di vita del paziente emodializzato.

There are many studies showing beneficial psychophysical effects of exercise in dialyzed patients. Moreover, it has been suggested that exercise positively correlates with better metabolism, better blood pressure control and with total hemoglobin. In our dialysis unit eight dialyzed patients (average age = 66.7 years), for eight weeks participated in physical training with bike (Reck Moto Med Letto) during dialysis treatment. Controls of glucose metabolism, blood pressure and dialysis efficiency index (Kt/V and URR) at rest and during exercise was performed. All patients responded well to exercise and expressed better muscular performance during and after exercise time. Our study showed in all patients improvement of Kt/V and URR index after physical exercise period, compared to exercise free time (p < 0.005). We suggest that exercise during dialysis treatment is safe and consents either better psychophysical performance or better dialytic efficiency.