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Updated: Apr 29, 2026
Arterial Pouch Microsurgical Bifurcation Aneurysm Model in the Rabbit
Published on: May 14, 2020
A modified stapling technique for the repair of an aneurysmal autogenous arteriovenous fistula
Matteo Tozzi1, Marco Franchin2, Giuseppe Ietto2
1Vascular Surgery, Department of Surgery and Morphological Sciences, University of Insubria School of Medicine, Circolo University Teaching Hospital, Varese, Italy; Center for Research on Organ Transplantation, Department of Surgery and Morphological Sciences, University of Insubria School of Medicine, Circolo University Teaching Hospital, Varese, Italy.
Objective:
An alternative surgical technique for the repair an aneurysmatic arteriovenous fistula (AVF) using a staple remodeling operation has been developed and the results are reported.
Methods:
All patients presenting with an aneurysmatic autogenous AVF of the upper extremities between January 2012 and December 2013 were included in the analysis. The AVF was approached laterally along the entire aneurysm and then remodeled using a stapler on the lateral side of the vein wall. All stenotic segments were excised. Follow-up included a clinical visit and echo color Doppler of the fistula and was performed 7, 15, and 30 days after the intervention and every 6 months thereafter.
Results:
We treated 14 patients (nine men [64.3%]) with a median age of 65 years (interquartile range [IQR], 62.5-69 years). Elective interventions were performed in 12 patients (85.7%), and two underwent emergency treatment because of postcannulation bleeding. Technical success was achieved in all cases. The mean duration of the intervention was 75 minutes (IQR, 61.15-83.45 minutes). No in-hospital deaths or major morbidities were observed. Median hospitalization time was 24 hours (IQR, 25-38 hours). Postoperative puncture was performed after a median delay of 12.5 hours (IQR, 12-17 hours). No patient was lost during the follow-up, which was a median of 16.5 months (IQR, 14-23 months). Primary functional patency was 12 of 14 (85.7%). Pseudoaneurysm, bleeding, hematoma, or infection was not observed.
Conclusions:
In our experience, the stapling technique proved to be easy, fast, and safe. Early follow-up outcomes showed excellent primary patency and confirmed the effectiveness of the technique because local complications were never observed.
