Emergency Ultrasound Diagnosis of a Pseudoaneurysm Associated With an Arteriovenous Fistula

Arshad, Faizan; Sutijono, Darrell; Moore, Christopher L.

doi:10.1111/j.1553-2712.2010.00758.x

Cited by 8 publications

(4 citation statements)

References 7 publications

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“…Sonographic assessment should include transverse and longitudinal measurements and assessment of flow and thrombus In addition, the inflow and outflow vessels should be assessed. Wall characteristics such as thickness and infection may also be possible [ 8 , 23 ].…”

Section: Managementmentioning

confidence: 99%

Aneurysms and pseudoaneurysms in dialysis access

Mudoni¹,

Cornacchiari²,

Gallieni

et al. 2015

Clin Kidney J

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Aneurysms are a common and often difficult complication seen with arteriovenous vascular access for haemodialysis. The purpose of this narrative review is to define and describe the scale of the problem and suggested therapeutic strategies. A narrative review of the published literature illustrated by individual cases is presented with the aim of summarising the relevant literature. The definitions of aneurysm are inconsistent throughout the literature and therefore systematic review is impossible. They vary from qualitative descriptions to quantitative definitions using absolute size, relative size and also size plus characteristics. The incidence and aetiology are also ill defined but separation into true aneurysms and false, or pseudoaneurysms may be helpful in planning treatment, which may be conservative, surgical or radiological. The lack of useful definitions and classification along with the multitude of management strategies proposed make firm evidence based conclusions difficult to draw. Further robust well designed studies are required to define best practice for this common problem.

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Section: Managementmentioning

confidence: 99%

Aneurysms and pseudoaneurysms in dialysis access

Mudoni¹,

Cornacchiari²,

Gallieni

et al. 2015

Clin Kidney J

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“…Traumatic shearing forces displace epiphyseal or ligamentous attachments and cause periosteal detachment and subsequent hemorrhage. 3 Ultrasound examination shows a well-defined, hypoechoic, nonvascular mass, which subsequently can appear heterogeneous, with elevation or compression of nearby structures and soft tissue thickening. An important differential diagnosis in this case was pseudoaneurysm, which on an ultrasound scan appears as a cystic structure with arterial communication and the presence of either a yin-yang sign on color Doppler or a to-and-fro sign on spectral Doppler imaging.…”

Section: Diagnosismentioning

confidence: 99%

“…1,4 The management of subperiosteal hematomas includes observation and pain control, or surgical evacuation if the hematoma is rapidly expanding or if complications exist. 3…”

Section: Diagnosismentioning

confidence: 99%

Male With Leg Pain

Vuong

Mitchell

Pade

et al. 2021

Annals of Emergency Medicine

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“…In pAVA, the size of the aneurysm sac and the width of the neck should be assessed, as should flow and thrombus within the sac. Inflow and outflow vessels and wall characteristics, such as thickness and infection, also may be possible to assess with Ultrasound scan (USS) (39, 40).…”

Section: Investigationmentioning

confidence: 99%

Aneurysms in Vascular Access: State of the Art and Future Developments

et al. 2017

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A master class was held at the Vascular Access at Charing Cross (VA@CX2017) conference in April 2017 with invited experts and active audience participation to discuss arteriovenous (AV) vascular access aneurysms, a serious and common complication of vascular access (VA). The natural history of aneurysms in VA is poorly defined, and although classifications exist they are not uniformly applied in studies or clinical practice. True and pseudo aneurysms of AV access occur. Whilst an AV fistula by definition is an abnormal dilatation of a blood vessel, an agreed definition of 18 mm, or 3 times accepted maturation diameter, is proposed. The mechanism of aneurysmal dilatation is unknown but appears to be a combination of excessive external remodeling, wall changes due to injury, and obstruction of outflow. Diagnosis of AV aneurysms is based on physical examination and ultrasound. Venography and cross-sectional imaging may assist and be required for the investigation of outflow stenosis. Treatment of pseudo aneurysms and true aneurysms of VA (AVA) is not evidence-based, but relies on clinical experience and available facilities. In many AVA, a conservative approach with surveillance is suitable, although intervals and modalities are unclear. Avoidance of rupture is imperative and preemptive treatment should aim for access preservation, ideally with avoidance of prosthetic materials. Different techniques of aneurysmorrhaphy are described with good results in published series. Although endovascular approaches and stenting are described with good short-term results, issues with cannulation of stented areas occur and, while possible, this is not recommended, and long-term access revision is recommended.

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Emergency Ultrasound Diagnosis of a Pseudoaneurysm Associated With an Arteriovenous Fistula

Cited by 8 publications

References 7 publications

Aneurysms and pseudoaneurysms in dialysis access

Aneurysms and pseudoaneurysms in dialysis access

Male With Leg Pain

Aneurysms in Vascular Access: State of the Art and Future Developments

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