Axillary aneurysm: An unusual complication of haemodialysis

Aneurysmal degeneration of the donor artery after vascular access

“…Similar to what is observed in posttraumatic AVFs, 14 the diagnosis of AD in all but one patient was made a long time after the AVF was closed. Although seldom noted, a certain degree of arteriomegaly often exists before the AVF is closed, as stated by Hale et al 13 More recently, Chemla et al 10 reported a rather homogeneous series of brachial artery aneurysms, with an average time for AD of 40 Ϯ 35.8 months; however, as in our series, they also reported rapid AD, from a few days to months. In all reported cases, as in the series by Chemla et al 10 and in seven of our 10 patients, the AD was located at the level of the brachial artery, eventually involving the axillary artery.…”

“…A patient surveillance program, with assessment of diameter by DUS scan, may help to diagnose AD earlier and to perform surgery before a bypass is needed. 11 Schunn 12 Hale 13 Nguyen 14 Battaglia 15 Sultana 16 Patients, No. As in arterial repair for standard atheromatous disease, vein bypass should be preferred to prosthetic bypass whenever feasible; as in other indications, it provides a better long-term patency.…”

Endovascular treatment of ruptured axillary and large internal mammary artery aneurysms in a patient with Marfan syndrome

“…The Table outlines the location, etiology, and treatment of reported axillary and IMA aneurysms in the current literature. [8][9][10][11][12][13][14][15][16][17] The decision to treat axillary and IMA aneurysms is based on size, presence of symptoms, and the risk for impending rupture. 4,5,18 Axillary artery aneurysms can cause ischemia due to thromboembolism.…”

Aneurysmal Degeneration of the Inflow Artery after Arteriovenous Access for Hemodialysis

“…During the study period, only one of the patients in the series required dialysis, and because of the patient's preference, a switch to peritoneal dialysis was performed. DISCUSSION Some studies have described an increase in the inflow artery (brachial or radial) diameter in the extremity with an AVF 3,4,6,7,11 accentuated by AVF flow 3 and the time after fistula creation, 4 and not prevented by fistula ligation or thrombosis. The mechanism is still unclear, but probably the increase in arterial flow following AVF produces an increase in wall stress and a decrease in wall thickness 8 ; these changes upregulate the local production of vasodilator agents (nitric oxide) and matrix metalloproteinases 2 and 9, which are also associated with adaptive arterial remodeling by internal elastic lamina fragmentation and arterial enlargement.…”

“…Like most published cases, the preference is to use autogenous conduits (rather than prosthetic grafts or allografts). 4e6, 11,13,14 But in contrast to other groups that use the great saphenous vein, ipsilateral arm vein of the same affected extremity, when not dilated or altered by previous AVFs, is preferred. The reason is to allow a quicker procedure with lower morbidity, and to preserve leg veins for future procedures in the arms or other vascular reconstructions.…”