Aneurysmal degeneration of the donor artery after vascular access

Abstract

AD is a rare but significant complication of vascular access. Surgical correction should be discussed in most cases due to potential complications. After resection, the choice of reconstructive conduit is not straightforward.

Aneurysmal Degeneration of the Brachial Artery after Vascular Access Creation: Surgical Treatment Results

“…10 Aneurysms can also develop in the inflow arteries after construction of AVFs for hemodialysis. [4][5][6] Several studies have described an increase in the diameter of the inflow artery after construction of an AVF in their extremity. [4][5][6]8,10 Arterial "growing" may be accentuated by AVF flow and the time after fistula creation.…”

“…[4][5][6] Several studies have described an increase in the diameter of the inflow artery after construction of an AVF in their extremity. [4][5][6]8,10 Arterial "growing" may be accentuated by AVF flow and the time after fistula creation. 4,8 There are four pathophysiological steps that can explain the transition from arteriomegaly to aneurysmal degeneration.…”

“…[4][5][6]8,10 Arterial "growing" may be accentuated by AVF flow and the time after fistula creation. 4,8 There are four pathophysiological steps that can explain the transition from arteriomegaly to aneurysmal degeneration. 6 First, upregulation of local production of vasodilator agents (nitric oxide) and matrix metalloproteinases 2 and 9, which results in loss of vessel's wall integrity and aneurysmal remodeling.…”

Brachial Artery Aneurysm With “Blue Finger Syndrome” After Ligation of a Remote Brachial Artery-Cephalic Vein Fistula

“…7 Upper extremity aneurysms are relatively infrequent when compared to other vessels in the body. In men, an aneurysm of the brachial artery will measure at a minimum of 6.15 mm; for women a minimum of 5.25 mm.…”

“…5,6 Additionally, studies suggest that immunosuppression with corticosteroids may promote the development of arterial aneurysms. 4,7 The combination of these factors presents a unique situation in patients with renal transplant who had been previously dialyzed with an AVF. We describe an immunosuppressed patient with renal transplant with pandilatation of his brachial artery who presented with delayed onset digital ischemia following ligation of a remotely created brachial artery-cephalic vein fistula.…”