Evaluating and treating venous outflow stenoses is necessary for the successful open surgical treatment of arteriovenous fistula aneurysms

Patel, Mitul S.; Street, Tiffany; Peden, Eric K.; Naoum, Joseph J.

doi:10.1016/j.jvs.2014.07.033

Cited by 24 publications

(19 citation statements)

References 12 publications

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“…These AVFAs are strongly associated with venous outflow stenosis. 3,4 In our series, 46.7% (Table I) of patients had such findings that required treatment at the time of AVFA revision.…”

Section: Discussionmentioning

confidence: 61%

“…Aneurysm formation remains a commonly encountered complication that threatens the longevity of these conduits. 2,3 Whereas approaches for the successful management of AVF aneurysms (AVFAs) have been previously described, 4,5 there remains appreciable subsequent loss of these critical conduits due to subsequent complications of reintervention, such as thrombosis and infection. Extracellular matrix (ECM; Cor-Matrix, Roswell, Ga) is an approved vascular conduit with antimicrobial properties.…”

mentioning

confidence: 99%

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Utility of a tubularized extracellular matrix as an alternative conduit for arteriovenous fistula aneurysm repair

DuBose

Fortuna

Charlton-Ouw

et al. 2016

Journal of Vascular Surgery

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“…These AVFAs are strongly associated with venous outflow stenosis. 3,4 In our series, 46.7% (Table I) of patients had such findings that required treatment at the time of AVFA revision.…”

Section: Discussionmentioning

confidence: 61%

mentioning

confidence: 99%

Utility of a tubularized extracellular matrix as an alternative conduit for arteriovenous fistula aneurysm repair

DuBose

Fortuna

Charlton-Ouw

et al. 2016

Journal of Vascular Surgery

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“…Previously reported techniques for treatment of AFV pseudoaneurysms and aneurysms have included the use of self-expanding stent grafts [14], prosthetic graft exoprosthesis reinforcement [8], use of Tubularized CorMatrix [15], aneurysmorrhaphy [12], and partial aneurysmectomy with native reconstruction [9,16] or prosthetic interposition [17]. Patel et al [18], reported that they performed resection of the aneurysm, followed with graft interpositioning or primary repair and no fistulas were compromised or lost as a result of the procedure. Georgiadis et al [19], in a study which they performed aneursym excision and graft interposition with PTFE graft, reported that patency rates of the repaired AVF as nearly 70%.…”

Section: Discussionmentioning

confidence: 99%

Surgical interventions for autogenous arteriovenous fistula aneurysms in hemodialysis patients

Özsin

Sanrı

Kahraman

et al. 2018

The European Research Journal

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Objectives. The aim of this study was to emphasize the importance of surgical intervention perfotmed before development of arteriovenous fistula (AVF) aneurysm complications. Methods. The patients were categorized into two groups: Patients undergoing elective surgery for autogenous AVF aneurysm were defined as elective group (Group 1), whereas those who underwent emergency surgery due to ruptured aneurysmal fistulas were defined as emergency group (Group 2). All elective cases were evaluated by doppler ultrasonography before surgery. All patients had temporary hemodialysis catheters. In the patients with salvaged fistulas, the fistulas was rested for 1 week. A new fistula was created in patients with not salvaged fistula. Results. A total of 31 patients (54.8% male, mean age: 41.2 ± 14.7 years) were in Group 1 and 7 patients (57.1% male, mean age: 53 ± 9.4 years) were in Group 2. Significant difference was observed between two groups in terms of fistula preservation. Salvaged fistulas were significantly higher in the Group 1 than Group 2 (p = 0.003). In Kaplan-Meier curves, cumulative primary AVF patency rates at 1, 3 and 6 months were 96.3%, 81.5%, and 77.8% in Group 1 and 66.7%, 66.7%, and 66.7% in Group 2, respectively (log-rank; p = 0.536). Conclusions. Consultation of these cases with a cardiovascular surgeon before they reach the rupture stage is an important condition for both the patency of the fistula and the vital risk of the patient.

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“…Furthermore, increased venous pressure may also result from stenosis within the central venous system and hasten aneurysm formation. Central venous stenosis typically results from extended central venous catheterisation and previously published studies suggest a broad range of incidence between 13% and 100% [15][16][17][18][19][20]. Imaging of the central venous system by fi stulography or ultrasound is not routine however, and potentially explains the wide incidence rates reported.…”

Section: Prevalence and Aetiologymentioning

confidence: 99%

Contemporary management of arteriovenous hemodialysis fistula aneurysms

2018

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SOUHRNÚvod: Aneurysma arteriovenózní fi stuly vzniká až u 60 % hemodialyzovaných pacientů. Často jde o asymptomatickou komplikaci, avšak s možným rizikem rozvoje závažných komplikací. Existuje řada chirurgických a endovaskulárních technik léčby, ale jasná klinická doporučení, kdy a jak intervenovat, chybějí. Autoři popisují klinický obraz, indikace k léčbě a současné možnosti léčby aneurysmatu arteriovenózní fi stuly. Metodika: Nesystematický přehled publikované literatury uvedených databází: MEDLINE, ScienceDirect, Scopus a Cochrane Database of Systematic Reviews. Do hodnocení byly zahrnuty publikace týkající se aneurysmatu arteriovenózní fi stuly a terapeutických možností od ledna 1973 do června 2016. Z hodnocení byly vyřazeny práce týkající se aneurysmatu a pseudoaneurysmatu protetických graftů. Výsledky: Aneurysma arteriovenózní fi stuly je defi nováno jako dilatace všech tří vrstev cévní stěny a průměrem větším než 18 mm. Indikace k léčbě jsou: bolestivost, riziko krvácení a neadekvátní průtok (nízký/vysoký). Samotný průměr aneurysmatu, stejně jako kosmetické důvody, by neměly být indikací k léčbě. Nejčastěji využívané terapeutické modality léčby aneurysma arteriovenózní fi stuly jsou: resekce s interpozicí, remodelační techniky a implantace stentgraftu. I když bylo publikováno několik léčebných metod, v současné době neexistuje publikace srovnávající jednotlivé léčebné techniky. Závěr: Asymptomatické aneurysma arteriovenózní fi stuly má být léčeno konzervativně s pravidelným sledováním. Vzhledem k absenci dostatečných důkazů neexistuje jasná strategie léčby pro aneurysma arteriovenózní fi stuly vyžadující intervenci. U symptomatického aneurysmatu, zejména s vysokým rizikem krvácení, by měla být co nejdříve indikována terapie.ABSTRACT Introduction: Aneurysms develop in up to 60% of patients with an arteriovenous fi stula. Frequently arteriovenous fi stula aneurysms are asymptomatic with the presence of symptoms potentially heralding the development a signifi cant complication. A range of surgical and endovascular techniques are available to manage arteriovenous fi stula aneurysms but clinical guidelines regarding the appropriate application of each approach are lacking. This review will examine the presentation, indications for treatment and management options for arteriovenous fi stula aneurysms. Methods: A non-systematic review of published literature in the following databases was performed: MEDLINE, ScienceDirect, Scopus and the Cochrane Database of Systematic Reviews. Publications relating to arteriovenous fi stula aneurysms and treatment options between January 1973 and June 2016 were considered for inclusion. Articles pertaining to aneurysms and pseudoaneurysms of prosthetic arteriovenous access sites were excluded. The literature search was supplemented by a review of the author's experience. Results: Arteriovenous fi stula aneurysms are defi ned by an expansion of the intimal, medial and adventitial layers of the vessel wall to a diameter of more than 18 mm. Treatment of arteriovenous fi stula aneur...

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Evaluating and treating venous outflow stenoses is necessary for the successful open surgical treatment of arteriovenous fistula aneurysms

Abstract: There is a high association of venous outflow stenoses and AVFA. Comprehensive therapy should encompass treatment of any venous outflow stenoses before open AVFA repair. A two-stage repair may decrease tunneled hemodialysis catheter use in patients with multiple aneurysms.

Cited by 24 publications

References 12 publications

Utility of a tubularized extracellular matrix as an alternative conduit for arteriovenous fistula aneurysm repair

Utility of a tubularized extracellular matrix as an alternative conduit for arteriovenous fistula aneurysm repair

Surgical interventions for autogenous arteriovenous fistula aneurysms in hemodialysis patients

Contemporary management of arteriovenous hemodialysis fistula aneurysms

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