Prolonging Life in Aneurysmatic Arteriovenous Fistulas; Aneurysmorrhaphy or Plication

Abstract

INTRODUCTION: The aim of this study was to share our surgical treatment approaches to patients who undervent arteriovenous fistula (AVF) and routine hemodialysis and developed aneurysm of AVF. METHODS: This study was designed retrospectively. Between May 2013 and November 2018, AVF aneurysms operated in patients with chronic renal insufficiency at XXXXX University Medical Faculty Cardiovascular Surgery Clinic were evaluated. The data were collected in the form of file scanning through the hospital automation system in digital environment. Patients with aneurysmatic AVF of 4mm or more were selected. The patients who underwent revision were included in the study, while the patients who had AVF cancellation by ligation were excluded. Patients were screened in terms of vascular access site, surgical technique and functionality. RESULTS: Out of 409 AVF aneurysm which was opened to a total of 347 patients, It was determined that 37 patients (16 males and 21 females; age average: 54.24 +- 19.26 years) who developed aneurysm had undergone revision. It was understood that radiosefalik (RC) AVF was observed in 12 patients, that basillic ven outcrop were seen in 2 patients (BVY) and AVF, and that brakiosefalik(BC) AVF was seen in 23 patients. It was determined that aneurysmorrhaphy had been performed in 27 patients, plication was performed in 7 patients and 3 of the patients who underwent aneurysmorrhaphy were treated in emergency conditions due to rupture. DISCUSSION AND CONCLUSION: Aneurysmorrhaphy and plication is an effective way of treatment for the re-use of the damaged AVF in patients with aneurysm who have already limitations to the vascular access.

Keywords

• arteriovenous fistula
• hemodialysis
• aneurysm
• aneurysmorrhaphy
• plication