WHAT THIS PAPER ADDSThe present study brings important additional information to current aneurysmal access guidelines.Objective: Aneurysms arising from arteriovenous fistulae are a common finding among dialysed patients and pose a risk of acute bleeding. The aim of this study was to perform a systematic review and meta-analysis evaluating the surgical options for the treatment of aneurysmal arteriovenous fistulae. Methods: A systematic review and meta-analysis of articles published between January 1973 and March 2019 describing the surgical treatment of arteriovenous fistulae aneurysms. Results: A total of 794 records were identified. After duplicate and low quality studies were removed, 72 full text articles were reviewed and from these 13 were included in the meta-analysis. The total number of patients was 597. Aneurysms were located in the upper arm in 289 (59%) cases and the smallest diameter of a treated aneurysm was 15 mm. The most frequent indication for treatment was bleeding prevention in 513 (86%) cases. Aneurysmorrhaphy was the surgical method of choice in all 13 studies. The pooled primary patency at 12 months was 82% (95% CI 69%e90%, 12 studies, I 2 ¼ 84%, p < .01). The 12 month primary patency rates were similar for aneurysmorrhaphy with external prosthetic reinforcement (85%, 95% CI 71%e93%, two studies, I 2 ¼ 0%, p ¼ .33) and aneurysmorrhaphy performed using a stapler (74%, 95% CI 61%e83%, four studies, I 2 ¼ 0%, p ¼ .48) and without a stapler (82%, 95% CI 60%e94%, six studies, I 2 ¼ 92%, p < .01). Conclusion: Aneurysmorraphy of arteriovenous fistulae is a procedure with acceptable short and long term results, with a low complication and aneurysm recurrence rate.

A large tumorous mass completely surrounding and compressing the coeliac trunk was identified on computed tomography in a young woman with a six-month history of progressive abdominal pain. The tumor was excised along with the coeliac trunk and the proximal parts of its branches. The hepatic artery was reconstructed with an aorto-hepatic autogenous bypass. Postoperatively the patient had neurogenic diarrhea, which subsided on medical treatment. Seven months after surgery the patient is in a good state of health and living a normal life.

Pancreaticoduodenal artery aneurysms are rare visceral artery aneurysms that may be associated with stenosis of the coeliac trunk. We present a case of a 48-year-old woman with a symptomatic aneurysm of the inferior pancreaticoduodenal artery caused by occlusion of the coeliac trunk due to median arcuate ligament syndrome. The patient was treated with an aorto-hepatic bypass and excision of the aneurysm. We discuss the case and the complexities and controversies in the treatment of this disease.

This review article summarizes the most recently available data covering the modern trends and methods in the diagnosis and treatment of mesenteric artery disease. Its aim is to point out the critical moments in the whole spectrum of matters such as early diagnosis and treatment of the chronic form of bowel ischemia, role of MDCT in prompt diagnosis, and urgent therapeutic modalities of treating its acute forms. To achieve the best possible results, we must minimize the time of diagnosis while the treatment has to be tailored individually to each patient according to occlusion type, age and co-morbidities (Fig. 2, Ref. 66).