Vascular rupture complicating transluminal angioplasty applied on a failed dialysis vascular access in a patient under chronic steroid therapy

We report a case of venous rupture complicating percutaneous transluminal angioplasty (PTA) applied on a failed dialysis vascular access (VA) in a patient on chronic steroid therapy. This complication resulted in a rapidly growing hematoma which was successfully controlled by a prolonged reinflation of the balloon catheter at the angioplasty site. The absence of oversizing of the balloon catheter and the low inflation pressure at which the perforation occurred suggest a vessel fragility which was probably induced by a long-standing steroid therapy. In dialysis patients in whom steroid therapy does not represent an infrequent therapeutic modality, this potential risk of vascular rupture should be carefully weighted while treating VA stenoses with the use of PTA.