title: Donor artery aneurysm formation following the ligation of haemodialysis arteriovenous fistula: a systematic review and case reports.
abstract: OBJECTIVE
  The purpose of this study is to investigate the pathogenesis, presentation and diagnosis of donor artery aneurysm formation following arteriovenous fistula (AVF) ligation and reach a consensus on their management.
  
  
  METHODS
  A systematic review of literature in Ovid, MedLine, Embase, Scopus and CINHAL in the English language from 1951 to 2014 was performed. This was accompanied by two case reports. A total of 12 articles with 23 case reports were identified. Variables including patient's demographics, signs, symptoms, fistula type, duration of fistula use, time to aneurysm formation, renal transplantation, diagnostic modality, aneurysm type and size, type of surgery and outcome were reviewed.
  
  
  RESULTS
  The data demonstrate a male predominance (5:1) and a median age of 47 years (range, 27-75 years). The median duration of access was 54 months (range, 6-300 months). The median time from ligation to aneurysm was 120 months (range, 6-280 months). The commonest aneurysm was of the brachial artery (BA, n = 21, 84%). The commonest type of AVF was radiocephalic (n = 15, 60%) followed by brachiocephalic AVF (n = 9, 36%). The management of choice was aneurysmectomy followed by interposition vein grafting (n = 12, 50%) with a median reported patency of 12 months (range, 1-38 months). This was followed by polytetrafluoroethylene (PTFE) grafting (n = 6, 25%) with a median reported patency of 6 months (range, 1-48 months).
  
  
  CONCLUSIONS
  The pathogenesis of donor artery aneurysms remains contentious. This review suggests that duplex is the investigative modality of choice and aneurysmectomy with interposition grafting is preferred over bypass.
authors.affiliation: 1 Department of Vascular and Endovascular Surgery, Mid Essex Hospitals Services NHS Trust, Essex - UK.
authors.forename: Ali
authors.initials: A
authors.lastname: Kordzadeh
authors.forename: Raquel M
authors.initials: RM
authors.lastname: D'Espiney Barbara
authors.forename: Ali S
authors.initials: AS
authors.lastname: Ahmad
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Hanif
authors.forename: Yiannis P
authors.initials: YP
authors.lastname: Panayiotopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001158:Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D012086:Reoperation; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency