title: Aneurysmal degeneration of brachial artery in kidney transplant receptors after arteriovenous fistula ligation.
abstract: OBJECTIVE
  True brachial artery aneurysms are. Recent case reports have suggested aneurysmal degeneration of brachial artery in kidney transplant receptors after arteriovenous fistula (AVF) ligation. We present a study on the evolution of the brachial artery in this context in our center.
  
  
  METHODS
  This is a descriptive study in kidney transplant receptors in whom AVF was ligated between 2008 and 2015. Patients with AVF in both upper limbs were excluded. Diameters of axillary artery, brachial artery in middle portion and its bifurcation, as well as brachial artery flow were measured using Dupplex ultrasound in AVF and contralateral limb. Both groups were compared using the Student t-test for paired samples.
  
  
  RESULTS
  20 patients were included in the study and had a mean age of 59.35 ± 2.49 years. The median time of use of AVF for hemodialysis was 729 days (range 120-6117) and the median time in which AVF was patent was 2261 days (range 791-7091). Mean diameters (in mm) of axillary artery, brachial in middle portion and bifurcation were respectively 9.33 ± 1.07, 7.5 ± 0.61 and 5.81 ± 0.43 in AVF arm and 5.6 ± 2.8, 4.4 ± 0.1, 4.9 ± 0.15 in control limb, finding statistically significant differences (p <0.01) in brachial and axillary arteries. 5 patients (25%) developed aneurysm, 2 of which (10%) underwent surgery and 3 are on follow up.
  
  
  CONCLUSIONS
  True incidence of brachial artery aneurysm in kidney receptors following AVF ligation is high. Careful follow up with physical examination and dupplex scanning are needed to find this complication.
authors.affiliation: Departamento de Cirurgia Vascular do Hospital Universitário de Valladolid, Espanha.
authors.forename: Ruth
authors.initials: R
authors.lastname: Fuente Garrido
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Brizuela Sanz
authors.forename: Ana Francisca
authors.initials: AF
authors.lastname: Sanchez Santiago
authors.forename: Diana
authors.initials: D
authors.lastname: Gutiérrez Castillo
authors.forename: Enrique M
authors.initials: EM
authors.lastname: San Norberto García
authors.forename: Carlos
authors.initials: C
authors.lastname: Vaquero Puerta