title: Partial Aneurysmectomy of Venous Aneurysms in Arteriovenous Dialysis Fistulas.
abstract: Upper extremity native arteriovenous fistulas (AVFs) continue to be the standard of care for hemodialysis patient's access. Although autogenous fistulas are superior to catheters and synthetic grafts, they are not without their own complications. One complication is venous aneurysms that can lead to skin erosion, bleeding, and site loss. Although traditionally repaired with ligation, interposition grafts, or stent placement, in this article, we discuss our experience with aneurysmorrhaphy utilizing a thoracoabdominal (TA) stapler. Thirteen aneurysms were treated with the TA stapler at a single, nonuniversity hospital for all patients from 2012 to 2014. The average aneurysm diameter was 3.6 cm, and the average fistula age was 57.9 months. There were no bleeding complications or recurrences. The primary patency was 80% at 6 months, with a primary assisted patency of 90% during the same time frame. Aneurysmorrhaphy with the TA stapler appears to be a safe and viable option for the treatment of venous aneurysms associated with AVFs.
authors: Philadelphia College of Osteopathic Medicine, Fort Washington, PA, USA carmenpiccolo@gmail.com.
authors: C
authors: C
authors: Piccolo
authors: Philadelphia College of Osteopathic Medicine, Fort Washington, PA, USA.
authors: N
authors: N
authors: Madden
authors: Cooper University Hospital Camden, NJ, USA.
authors: M
authors: M
authors: Famularo
authors: Crozer Chester Medical Center Upland, PA, USA.
authors: G
authors: G
authors: Domer
authors: Crozer Chester Medical Center Upland, PA, USA.
authors: W
authors: W
authors: Mannella
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000175:diagnosis / Q000601:surgery*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012086:Reoperation; D012189:Retrospective Studies; D017792:Surgical Stapling; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency; D014680:Veins / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult
keywords: AVF aneurysm; dialysis complications; stapled resection