[Urgent Treatment of Radio-Cephalic Aneurysm in a Renal Transplant Patient]

Arteriovenous fistula (AVF) for hemodialysis can lead to various complications in transplanted patients, particularly on an iatrogenic basis and due to hemodynamic changes: aneurysm - whether venous, arterial, or arteriovenous - is one such complication. Shear stress and the activation of oxygen radicals can affect the remodeling of the vessel wall (type IV and V collagen). We describe a case of a rare aneurysm of the anastomotic chamber. In January 2025, a 55-year-old woman with a well-functioning kidney transplant on triple anti-rejection therapy presented to our clinic. She complained of a painful pulsation at the site of the distal left radio-cephalic AVF anastomosis, which had developed over the past two days. An ultrasound-color Doppler examination revealed an aneurysm of the anastomotic chamber involving the radial artery. We recommended evaluation in the emergency department for surgical assessment. The patient underwent aneurysmectomy with reconstruction of the wall continuity and ligation of the AVF a few hours later. Conclusions. Thanks to the color Doppler ultrasound examination, we diagnosed a rare arteriovenous aneurysm of the AVF in a transplanted patient. Monitoring seems necessary in this category of patients for the management of severe complications that may be favored by anti-rejection therapy.