title: The aneurysmal arteriovenous fistula - morphological study and assessment of clinical implications. A pilot study.
abstract: Aneurysmal dilation of arteriovenous fistulae used for haemodialysis is a recognised complication but its clinical significance is a contentious issue. Our aims were to describe aneurysmal fistulae morphologically and clinically.Sixty patients underwent duplex scanning to measure the maximum diameter and skin thickness of their fistula. Haemodialysis function and bleeding risk were assessed clinically.The 75th percentile of maximum diameter was 2.05 cm. In addition to conventional diameter measurement, we describe a novel volume measurement technique which may be of value. No relationship was found between maximum diameter or volume and function, skin thickness or bleeding.Some studies define aneurysm at 2 cm (75th percentile); however, this definition and other arbitrary definitions lack clinical significance. This work suggests that fistula dilation should be considered together with clinical issues when determining the clinical significance of an aneurysm. Our finding that haemodialysis function, skin thickness and bleeding were not associated with diameter needs further study.
authors.affiliation: School of Medicine, University of Dundee, Scotland, UK.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Watson
authors.affiliation: School of Medicine, University of Dundee, Scotland, UK.
authors.forename: Maeve
authors.initials: M
authors.lastname: Gallagher
authors.affiliation: Department of Vascular Surgery, Ninewells Hospital and Medical School, Scotland, UK.
authors.forename: Rose
authors.initials: R
authors.lastname: Ross
authors.affiliation: Department of Nephrology, Ninewells Hospital and Medical School, Scotland, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Severn
authors.affiliation: Department of Vascular Surgery, Ninewells Hospital and Medical School, Scotland, UK.
authors.forename: Janos
authors.initials: J
authors.lastname: Nagy
authors.affiliation: Dundee Epidemiology and Biostatistics Unit, University of Dundee, Scotland, UK.
authors.forename: Lynda
authors.initials: L
authors.lastname: Cochrane
authors.affiliation: Department of Vascular Surgery, Ninewells Hospital and Medical School, Scotland, UK gareth.griffiths@nhs.net.
authors.forename: Gareth D
authors.initials: GD
authors.lastname: Griffiths
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019106:Postoperative Hemorrhage / Q000209:etiology; D011237:Predictive Value of Tests; D011379:Prognosis; D006435:Renal Dialysis; D012307:Risk Factors; D012606:Scotland; D012867:Skin / Q000000981:diagnostic imaging; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color
keywords: Aneurysm; colour doppler; renal dialysis; surgical arteriovenous shunt; ultrasonography