Abstract
One complication of autogenous arteriovenous fistula (AVF) for hemodialysis is the formation of a venous aneurysm (VA). The treatment of massive aneurysmal AVF generally involves ligation or resection with the use of prosthetic interposition. Partial aneurysmectomy, with or without reduction venoplasty, has been suggested to treat such a complicated AVF to maintain an all-autogenous access. The purpose of this study was to describe these procedures and examine their outcomes. From January 2008 to May 2012, 14 patients (64% males) with complicated VAs were treated by partial aneurysmectomy with reduction venoplasty for a diffusely dilated venous segment. Patients with an infected aneurysm or central vein stenosis were not included. The surgical technique and the postoperative outcome were described. Patients were a mean age of 37.2 ± 12.2 years. Twenty-five aneurysms and four diffusely dilated segments (7, 10, 15, and 21 cm in length) were treated. Four patients (29%) presented with one aneurysm, nine (64%) with two aneurysms, and one (7%) with three aneurysms. The main clinical indications for intervention were skin necrosis and erosion with imminent danger of bleeding in nine (64%), stenosis related to aneurysm in one (7%), an...Continue Reading
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