Surgical revision of complicated false and true vascular access–related aneurysms

Abstract

Surgical revision of complicated false and true AVA-related aneurysms reveals acceptable postintervention primary patency rates and therefore is justified. This outcome measure was superior in the following specific groups of corrections: autogenous were better than prosthetic, true aneurysms were better than false aneurysms, patients with one or two previous AVAs in the revised arm were better than those with more than two previous accesses in the revised arm, and finally, forearms were better than those in the upper arm.

Staple aneurysmorrhaphy to salvage autogenous arteriovenous fistulas with aneurysm-related complications

“…Another option is ligation with interposition bypass using a prosthetic graft. 5 However, this converts the access into an arteriovenous graft (AVG) with inferior patency and higher infection risk. 12 Interposition bypass has been done using great saphenous vein, but this is limited by the size and quality of the vein.…”

“…1 Several surgical techniques have been used to address aneurysmal AVFs. [5][6][7][8] Surgical aneurysmorrhaphy involves resection of a portion of the aneurysmal wall and primary closure using the remaining wall, thus preserving an autogenous AVF. Several authors have performed surgical aneurysmorrhaphy using a mechanical stapler.…”

Stent graft treatment for hemodialysis access aneurysms

“…The indications for intervention were signs of impending rupture such as rapid increase in size of the aneurysm, poor eschar formation over the puncture site, spontaneous bleeding or difficulty in achieving hemostasis at the conclusion of the hemodialysis session, and various other indications such as questionable viability of the skin over the aneurysm due to thinning, symptomatic aneurysms (pain), local infection, or limitation of cannulation sites by the size or number of the aneurysms. 1,4,5 Revisions were not done for esthetic reasons for access aneurysms that did not fulfill the recommended criteria for revision.…”

Surgical Approaches to Symptomatic Arteriovenous Fistula Aneurysms: a Single-Center Experience

“…In the surgical treatment of AVF aneurysms, several methods such as ultrasound-guided compression, thrombin injection, aneurysm plication, ligation, and graft interposition can be used [9]. In a study including patients undergoing graft interposition following ligation, one-year patency rate was reported to be 70% [10]. In our study, aneurysm resection was performed in eight patients, partial resection combined with PTFE graft interposition of the resected segment in four patients, and aneurysmatic segment plication in nine patients.…”