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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Vascular access is a fundamental element in hemodialysis therapy. Even though an Arteriovenous Fistula (AVF) is preferable, the use of a central venous catheter (CVC) is often inevitable. CVC use may lead to long-term complications such as central vein stenosis (CVS). CVS encompasses a wide range of clinical presentations from asymptomatic to severe superior vena cava syndrome due to central vein occlusion. This case reports a hemodialysis patient with CVS presenting a rare cutaneous manifestation of Acroangiodermatitis (AAD) secondary to venous hypertension.
A 53-year-old man with end-stage kidney disease (ESKD) on hemodialysis for the past 16 years, presented with an extensive crusted ulcer accompanied by edema extending from right shoulder to the fingers, along with venectasia around the right AVF cannulation site. The symptoms had been progressing for eight months, initially presenting as swelling of the right arm extending to the chest, which worsened particularly after hemodialysis sessions. The patient underwent several methods of vascular access with temporary CVC insertions in the right neck, AVF in the left lower and upper arm, before establishing a radiocephalic fistula in the right lower arm for the past eight years. Angiographic evaluation revealed a right subclavian vein total occlusion that was impenetrable by a guidewire. Accordingly, new vascular access was created, leading to partial improvement of the edema. Four months later, ulceration with yellowish discharge developed at the previous AVF cannulation site, evolving into thick enlarged crusted plaques unresponsive to topical antibiotics. On examination, the patient was hypertensive with conjunctival pallor, elevated jugular venous pressure (JVP), and venectasia over the anterior thoracic wall. The right arm showed hyperpigmented erythematous plaques with ulceration and overlying crusts. Acroangiodermatitis was diagnosed based on dermoscopic and histopathological findings. The patient underwent percutaneous transluminal angioplasty (PTA), followed by a planned wide excisional necrotomy, AVF ligation, intraoperative biopsy, and defect closure with a split-thickness skin graft.
Central vein stenosis (CVS) is a major cause of venous hypertension in patients with AVF. CVC insertion and long-standing AVF are some risk factors of CVS. Venous hypertension rarely presents with dermatologic manifestations such as acroangiodermatitis (AAD) resulting from reactive proliferation of dermal vessels. Management of AAD in hemodialysis patients primarily focuses on addressing the underlying vascular obstruction. In this case, the chosen therapeutic strategy consisted of percutaneous transluminal angioplasty (PTA) as the recommended initial therapy, followed by a planned wide excisional necrotomy, right arteriovenous fistula (AVF) ligation, intraoperative biopsy, and defect closure with a split-thickness skin graft to preserve the affected limb.
This case highlights a complex vascular access complication in a hemodialysis patient that required a multidisciplinary approach. Early recognition and prompt management of central vein stenosis and its complications, including acroangiodermatitis, are crucial to optimize patient outcomes.
