Aneurysms in vascular access: state of the art and future developments

The Journal of Vascular Access
Nicholas InstonDomenico Valenti

Abstract

A master class was held at the Vascular Access at Charing Cross (VA@CX2017) conference in April 2017 with invited experts and active audience participation to discuss arteriovenous (AV) vascular access aneurysms, a serious and common complication of vascular access (VA). The natural history of aneurysms in VA is poorly defined, and although classifications exist they are not uniformly applied in studies or clinical practice. True and pseudo aneurysms of AV access occur. Whilst an AV fistula by definition is an abnormal dilatation of a blood vessel, an agreed definition of 18 mm, or 3 times accepted maturation diameter, is proposed. The mechanism of aneurysmal dilatation is unknown but appears to be a combination of excessive external remodeling, wall changes due to injury, and obstruction of outflow. Diagnosis of AV aneurysms is based on physical examination and ultrasound. Venography and cross-sectional imaging may assist and be required for the investigation of outflow stenosis. Treatment of pseudo aneurysms and true aneurysms of VA (AVA) is not evidence-based, but relies on clinical experience and available facilities. In many AVA, a conservative approach with surveillance is suitable, although intervals and modalities are u...Continue Reading

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Citations

Apr 10, 2018·The Journal of Vascular Access·Kenneth AbreoAdrian P Abreo
Oct 17, 2018·The Journal of Vascular Access·Masaki MuramatsuKen Sakai
Jan 14, 2021·The Journal of Vascular Access·Alexis M CahalaneJie Cui
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Dec 28, 2019·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Peter BalážStephen O'Neill

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Methods Mentioned

BETA
vascular bypass

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