Surgical interventıons to save autogenic dialysis access in aneurysmal arteriovenous fistulas

The aim is to share our surgical approaches for the removal of aneurysmatic dilatation by preserving the vascular access pathway in aneurysmatic arteriovenous fistulas (AVF).

This study includes patients were admitted between September 2017 and May 2022 and were found to have true aneurysms in their upper extremity AVF. Patients were treated with partial aneurysmectomy combined with aneurysmorrhaphy or autologous vein graft interposition after total aneurysmectomy.

Six patients who underwent aneurysmoraphy after partial aneurysmectomy were named Group I. The mean age of the patients was 49, and the aneurysm diameter was 4.1 cm. 14 patients who underwent autologous vein interposition after aneurysmectomy were named Group II. The mean age of the patients was 58, and the aneurysm diameter was 4.4 cm. 13 patients met the need for hemodialysis with new AVF within 31 days (± 4-11 days). Due to the detection of insufficient post-operative flow in 1 patient (flow rate 180-200 mL/min) was taken to dialysis with alternative accesses.

In AVF aneurysms, it is possible to save the vascular access path with surgical treatments applied under elective conditions.