Objective To investigate the mid- and long-term effects of different surgical methods to resect arteriovenous fistula aneurysm (AVFa) on fistula function. Methods We retrospectively analyzed the clinical data of 36 patients undergoing surgical treatment of AVFa at our center between Feb. 2016 and Feb. 2020. Eighteen patients underwent aneurysmorrhaphy to reshape the new AVF, 13 ineligible patients underwent aneurysm resection with outflow reconstruction to construct a new dialysis pathway, and 5 patients had only aneurysm resection and failed to retain fistula function. All patients were followed up for 36 months. Results The 18 patients undergoing aneurysmorrhaphy dialyzed with the primary AVF immediately after surgery, with normal AVF function and no recurrence of aneurysm in follow-up study. Of the 13 patients undergoing reconstruction of the outflow tract, 5 had anastomotic stricture in the 36 months period of follow-up. The fistula became patent after PTA treatment and could be used normally. The remaining 5 patients underwent AVFa resection. Conclusion Aneurysmorrhaphy is an effective treatment for AVFa in hemodialysis patients, can preserve adequate vascular resources in forearm for hemodialysis, and has satisfactory mid- and long-term patency rates.
XIE Zhan-Chang
,
LIU Min
,
WANG Wei
,
YU Kang-Min
. Mid- and long-term therapeutic efficacy of surgical treatment for arteriovenous fistula aneurysm[J]. Chinese Journal of Blood Purification, 2024
, 23(09)
: 694
-697
.
DOI: 10.3969/j.issn.1671-4091.2024.09.013
[1].参考文献
[2]Lok C E, Huber T S, Lee T, et al.KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update[J].Am J Kidney Dis, 2020, 75(4 Suppl 2):S1-S164
[3]Joshi A S, Agrawal D P.Arteriovenous fistula takedown in hemodialysis patients: our experience of 26 cases[J].Kardiochir Torakochirurgia Pol, 2020, 17(3):132-136
[4]Arasu R, Jegatheesan D, Sivakumaran Y.Overview of hemodialysis access and assessment[J].Can Fam Physician, 2022, 68(8):577-582
[5]Almerey T A, Oliver J D, Jorgensen M S, et al.Upper extremity reconstruction following open surgical repair of giant arteriovenous fistula aneurysm: clinical case and systematic review of the literature[J].Acta Biomed, 2020, 91(4):e2020093-e2020095
[6]Meola M, Marciello A, Di Salle G, et al.Ultrasound evaluation of access complications: Thrombosis,aneurysms,pseudoaneurysms and infections[J].J Vasc Access, 2021, 22(1_suppl):71-83
[7]Saati A, Puffenberger D, Kirksey L, et al.The role of hemodialysis access duplex ultrasound for evaluation of patency and access surveillance[J].Cardiovasc Diagn Ther, 2023, 13(1):190-195
[8]Mohamed I, Kamarizan M, Da S A.Medical adjuvant treatment to increase patency of arteriovenous fistulae and grafts[J].Cochrane Database Syst Rev, 2021, 7(7):C-D002786
[9]Arasu R, Jegatheesan D, Sivakumaran Y.Overview of hemodialysis access and assessment[J].Can Fam Physician, 2022, 68(8):577-582
[10]Rahil M A.Successful treatment of a venous pseudoaneurysm in a brachiobasilic fistula using ultrasound-guided manual compression: two case reports[J].J Ultrasound, 2019, 22(3):345-347
[11]Balá? P, Roko?ny S, Bafrnec J, et al.Repair of Aneurysmal Arteriovenous Fistulae: A Systematic Review and Meta-analysis[J].Eur J Vasc Endovasc Surg, 2020, 59(4):614-623
[12]Yoo Y S.Surgical management of a giant venous aneurysm in an autogenous arteriovenous fistula with the vessel loop shoelace technique for wound closure: A case report[J].Medicine (Baltimore), 2021, 100(48):e28072-e28076
[13]Chang R, Alabi O, Mahajan A, et al.Arteriovenous fistula aneurysmorrhaphy is associated with improved patency and decreased vascular access abandonment[J].J Vasc Surg, 2023, 77(3):891-898
[14]Chang R, Alabi O, Mahajan A, et al.Arteriovenous fistula aneurysmorrhaphy is associated with improved patency and decreased vascular access abandonment[J].J Vasc Surg, 2023, 77(3):891-898
[15]Tang Q H, Yang H, Chen J, et al.Comparison between transposed arteriovenous fistulas and arteriovenous graft for the hemodialysis patients: A meta-analysis and systematic review[J]. J Vasc Access, 2022:929298203.[J].J Vasc Access, 2023, 46(9):1136-1143
[16]Ratnam L, Karunanithy N, Mailli L, et al.Dialysis Access Maintenance: Plain Balloon Angioplasty[J].Cardiovasc Intervent Radiol, 2023, 46(9):1136-1143
[17]García-Medina J, Maldonado-Cárceles A B, García-Alfonso J J, et al.Stent graft deployment in haemodialysis fistula: patency rates in partially thrombosed aneurysm and residual thrombi[J].Clin Kidney J, 2021, 14(3):814-819
[18]Stegmayr B, Willems C, Groth T, et al.Arteriovenous access in hemodialysis: A multidisciplinary perspective for future solutions[J].Int J Artif Organs, 2021, 44(1):3-16
[19]Dolmatch B, Cabrera T, Pergola P, et al.Prospective,randomized,multicenter clinical study comparing a self-expanding covered stent to percutaneous transluminal angioplasty for treatment of upper extremity hemodialysis arteriovenous fistula stenosis[J].Kidney Int, 2023, 104(1):189-200
[20]Luo Q, Liu H, Yang Q.Analysis of Factors Influencing Restenosis after Percutaneous Transluminal Angioplasty[J].Blood Purif, 2022, 51(12):1031-1038