Our experiences with hemodialysis arteriovenous fistula aneurysm

Abstract

Objectives: This study presents the short-term clinical data of surgical treatment strategies of patients with hemodialysis arteriovenous fistula (AVF) aneurysms. Patients and methods: Between January 2010 and July 2019, a total of 103 patients (69 males, 34 females; mean age 52.3±20.6 years; range, 18 to 87 years) who underwent elective AVF surgery due to AVF aneurysms (≥4 cm) were included in this retrospective study. Operative techniques and patients' outcomes were reviewed and analyzed. Results: Aneurysm resection and graft interposition, ligation, and aneurysmorrhaphy (partial aneurysm resection and plication) were performed in 62, 5, and 14 patients with radiocephalic AVF aneurysms, respectively. Aneurysm resection and graft interposition, aneurysm ligation, and aneurysmorrhaphy were performed in 10, 7, and 5 patients with brachiocephalic and brachiobasilic AVF aneurysms, respectively. Wound infection, hematoma, and seroma were seen as postoperative complications in 5, 4, and 11 patients, respectively. The mean postoperative fistula flow rate of the patients with brachiocephalic and brachiobasilic AVFs was 402±48 mL/min. The mean postoperative fistula flow rate of the patients with radiocephalic AVFs was 325±69 mL/min. There was no in-hospital mortality. Conclusion: It should be kept in mind that AVF aneurysms may cause serious consequences, if left untreated before the development of complications. The surgical treatment of AVF aneurysms not only reduces the risk for developing complications, but also provides the protection of the AVF in most patients.

Research on comprehensive analysis of patient comfort and complication rate using haemodialysis indwelling needles in AVF puncture in haemodialysis treatment

“…Previous studies have suggested that the commonly observed complications of AVF are related to an inadequate maturation of AVF, stenosis, aneurysms, infections, thrombosis, high flow rate AVF and steal syndrome resulting from ischaemia. 6 , 25 , 26 Failure of the AVF is mostly associated with stenosis of the artery of the vein. However, these complications can be corrected through endovascular or surgical techniques; thus, shorter segments resulting from stenosis can be treated using percutaneous transluminal angioplasty while surgical replacements are the recommended standards in extensive stenotic segments.…”