title: Endovascular treatment of arteriovenous graft pseudoaneurysms, indications, complications, and outcomes: a systematic review.
abstract: There are limited data regarding endovascular treatment of arteriovenous graft (AVG) pseudoaneurysms using stent grafts. We performed a comprehensive literature review on the use of stent grafts in the treatment of AVG pseudoaneurysms. We included 10 studies (121 patients). The mean AVG age was 3.1 years (95% confidence interval [CI]: 2.2-4) and pseudoaneurysm mean diameter was 34 mm (95% CI: 23-46). The majority (71%) of the pseudoaneurysms were located on the arterial limb of the AVG and 77% presented with venous anastomosis stenosis requiring angioplasty. The mean number of stents used to treat one lesion was 1.4 (95% CI: 1.3-1.5). The technical success rate of pseudoaneurysm isolation was 100% in all studies and 100% of patients received hemodialysis using the AVG after pseudoaneurysm treatment without the need for catheter placement. The primary patency rates for 1, 3, and 6 months were 81%, 73%, and 24%. Secondary patency was 80%, 77%, and 74% at 1, 3, and 6 months. Arteriovenous graft thrombosis occurred in 12% of patients. Arteriovenous graft infection developed in 35% of cases. Arteriovenous graft pseudoaneurysm treatment using stent grafts is effective in managing even large pseudoaneurysms and has acceptable primary and secondary patency rates. Graft infection was a relatively frequent complication.
authors.affiliation: Nephrology Division, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
authors.forename: Marius C
authors.initials: MC
authors.lastname: Florescu
authors.forename: Fang
authors.initials: F
authors.lastname: Qiu
authors.forename: Troy J
authors.initials: TJ
authors.lastname: Plumb
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Fillaus
mesh_terms: D017541:Aneurysm, False / Q000150:complications / Q000628:therapy*; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000628:therapy*; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome
keywords: Arteriovenous graft; hemodialysis; pseudoaneurysm; stent graft