Salvage Treatment for Venous Aneurysm Complicating Vascular Access Arteriovenous Fistula: Use of an Exoprosthesis to Reinforce the Vein after Aneurysmorrhaphy

Bérard, Xavier; Brizzi, Vincenzo; Mayeux, Sophie E.; Sassoust, G.; Biscay, D.; Ducasse, Éric; Bordenave, Laurence; Corpataux, Jean-Marc; Midy, D.

doi:10.1016/j.ejvs.2010.01.021

Cited by 38 publications

(55 citation statements)

References 15 publications

(14 reference statements)

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“…This technique was developed by our group in 2008 9 and has been validated 10 and internationally adopted for aneurysmal AVF salvage. 11 A detailed video of this procedure can be found online (http://aneurysmorrhaphy.eu-How to use section). In brief, the aneurysmal fistula was mobilized, and general heparinization (5000-10 000 IU) was performed.…”

Section: Avf Reductionmentioning

confidence: 99%

Cardiac remodeling after reduction of high-flow arteriovenous fistulas in end-stage renal disease

et al. 2016

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In patients with end-stage renal disease, excessive blood flow through an arteriovenous fistula (AVF) may lead to volume overload-induced cardiac remodeling and heart failure. It is unclear which patients with hyperfunctional AVF may benefit from AVF reduction or ligation. The indication for the procedure is often based on AVF flow. Because cardiac remodeling is driven by increased venous return, which is equivalent to cardiac output, we hypothesized that an elevated cardiac index (CI) might better identify subjects with reverse remodeling after AVF reduction. Thirty patients (age 52±12 years, 73% male) with AVF flow ⩾1.5 l min(-1) underwent comprehensive echocardiographic evaluations before and after AVF reduction. At baseline, 16 patients had a normal CI (2.5-3.8 l min(-1) m(-2)) and 14 had a high CI (4.0-6.0 l min(-1) m(-2)). A left ventricular end-diastolic diameter decrease after operation was predicted by elevated baseline CI (P<0.01), but not elevated AVF flow (P=0.07). There was a significant decrease in CI, left ventricular mass, left atrial and right ventricular diameter and pulmonary systolic pressure in the high CI group but not in the normal CI group. After AVF reduction, systemic vascular resistance decreased in the normal CI group, whereas it did not change in the high CI group. In conclusion, reduction of high-flow AVF leads to reverse cardiac remodeling but only in patients with elevated CI. The variability of the response of systemic vascular resistance to AVF flow may explain this observation. Increased CI but not increased AVF flow may better determine candidates for AVF reduction.

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Section: Avf Reductionmentioning

confidence: 99%

Cardiac remodeling after reduction of high-flow arteriovenous fistulas in end-stage renal disease

et al. 2016

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“…The cause of the dilatation was degenerative mechanisms in the vein wall that resulted from repeated cannulation during dialysis, the increased blood pressure in the arterialized vein and the repeated angioplasty for the treatment of recurrent stenosis [26]. …”

Section: Discussionmentioning

confidence: 99%

Venous aneurysm complicating arteriovenous fistula access and matrix metalloproteinases

et al. 2015

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IntroductionAn arteriovenous fistula (AVF) for placed for hemodialysis may be burdened by one particular complication—the formation of a venous aneurysm. It has been shown that matrix metalloproteinases (MMPs) and neutrophil gelatinase-associated lipocalin (NGAL) could represent markers of disease in both venous and arterial vessels.Materials and methodsThis case study reports a rare case of enormous venous aneurysm-correlated MMP and NGAL levels in a woman with an AVF.ResultsSignificantly higher levels of plasma MMP-1, MMP-8, MMP-9, and NGAL were detected in this patient during aneurysmal evaluation before the surgery; these levels significantly decreased 1, 3 and 6 months after surgery.ConclusionMMP and NGAL levels could represent a marker of aneurysmal disease, and their plasma evaluation could help physicians to stratify the risk of complications in patients with an AVF.

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“…Berard et al noted that reinforced venous aneurysmorrhaphy is effective in controlling venous dilation and achieving patency 11. Also, Balaz et al found that to offset the weakening of the venous wall by suture following aneurysmorrhaphy, an external polyethylene terephthalate prosthesis needed to be implanted in the vein to prevent the development of intimal hyperplasia in the de novo created AV fistula 12.…”

Section: Discussionmentioning

confidence: 99%

Aneurysm of the tibial-saphenous fistula in hemodialysis patient: the results of surgical treatment

Gülbaran

2011

VHRM

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Arteriovenous fistulas are widely used for hemodialysis patients with end-stage renal failure. Due to the lack of suitable veins because of the arteriovenous fistulas previously opened in the upper extremity, alternative access routes are being tested. Few complications of long-term alternative arteriovenous fistulas have been reported in the literature. We report the results of surgical repairs of aneurysms that occurred on anterior tibial-saphenous arteriovenous fistulas (along the vein) in patients with end-stage renal disease after 5 years on hemodialysis.

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Salvage Treatment for Venous Aneurysm Complicating Vascular Access Arteriovenous Fistula: Use of an Exoprosthesis to Reinforce the Vein after Aneurysmorrhaphy

Abstract: Reinforced venous aneurysmorrhaphy is effective in controlling venous dilation and achieving patency. Reduction of high-flow rates was not always achieved. Further study is needed to evaluate long-term efficacy of this treatment.

Cited by 38 publications

References 15 publications

Cardiac remodeling after reduction of high-flow arteriovenous fistulas in end-stage renal disease

Cardiac remodeling after reduction of high-flow arteriovenous fistulas in end-stage renal disease

Venous aneurysm complicating arteriovenous fistula access and matrix metalloproteinases

Aneurysm of the tibial-saphenous fistula in hemodialysis patient: the results of surgical treatment

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