Arteriovenous fistula takedown in hemodialysis patients: our experience of 26 cases

Abstract

Introduction Creation of arteriovenous fistulas (AVF) for providing vascular access in patients dependent on hemodialysis is a very frequent type of surgery. One of the common complications of such a fistula is the formation of an aneurysm or a pseudoaneurysm and the risk of impending rupture. These are a few of the reasons why such surgically created AVF have to be taken down surgically. Some of these may be taken down for cosmetic reasons electively while some present in an emergency due to rupture of the aneurysm itself. Aim This is a retrospective study of 26 patients who underwent AVF takedown at our center over a period of 4 years. Material and methods We intended to study the patient profile, the surgery that they underwent and the post-operative course of these patients. Results We found that aneurysm formation was the most common reason for a takedown, although we did see a good percentage of patients who presented to us with a ruptured AVF aneurysm. Our procedure was a ligation of the aneurysm with resection of the aneurysmal segment and maintaining arterial continuity. No attempt to preserve the fistula was made in any of these cases. Conclusions This article gives a brief overview of our experience in AVF takedown.

Complications Related Comorbidities of Arteriovenous Fistula (Avf) Creation as Hemodialysis Access for End Stage Renal Disease (Esrd) in Ben Mboi District Hospital, Ruteng Flores Indonesia

“…Physical examination along with Doppler ultrasonography is used to diagnose pseudoaneurysm patients. The KDOQI recommends surgical repair for the treatment of pseudoaneurysms 2,6,30 .…”

“…AVF ligation followed by pseudoaneurysm excision is the standard therapy for a pseudoaneurysm. All patients in this research got pseudoaneurysm repair treatment while keeping their existing AVF access 6,31 .…”

“…After surgery for an arteriovenous fistula (AVF), two things must be considered: complications and maturation. Many research in many locations in Indonesia have described vascular access profile data 6,7 . However, there are few studies that thoroughly explain and detail difficulties, and there is no data on vascular access especially AVF in places with limited facilities, such as on the island of East Nusa Tenggara.…”

Arteriovenous fistula creation by nephrologist and its outcomes: a prospective cohort study from Vietnam

“…There has been an increased number of patients with end-stage renal disease (ESRD) worldwide including Vietnam that leads to the high demand for hemodialysis [ 1 , 2 ]. Arteriovenous fistulas (AVF) are the gold standard vascular access for chronic hemodialysis treatment because of lower risks of complications associated with long-term use compared to arteriovenous grafts (AVG) and permanent cuff catheters [ 3 , 4 ]. Early referral of patients with ESRD to vascular surgeons is crucial to allow adequate time for planning an AVF creation and enable it to mature [ 2 ].…”

Rupture infected pseudoaneurysm on brachiocephalic AV-fistula: emergency and definitive management

“…2, 3 Bleeding at the vascular access requires surgical emergencies to reduce the risk of ischemic events in the patient's forearm and reduce mortality risk in the patient. 4,5 The purpose of this case report is to present a 55-year-old man with bleeding on the AV-fistula surgery site, accompanied with pain and swelling on his forearm that occurred 3 hours before admission to the hospital.…”