SUN-252 Management and Treatment of Aneurysms AVF artery venous fistula
Year: 2020
Type: conference-abstract
Abstract: End-stage renal disease patients is rising all over the world. The follow-up of vascular accesses aims to preserve them trying to avoid complications and the need for catheters since these are related to a higher morbidity and mortality rate. The formation of aneurysms in hemodialysis patients is a frequent complication and is associated with weakening of the wall and drainage stenosis. We try to avoid catheter placement; and preserve vascular access by preventing their depletion. 1238 surgeries were performed between April 2016 to September 2019, 41 (3.3%) AVF aneurysm repairs were performed. 30 were on native AVF and 11 on prosthetic AVF. 40 were repaired due to risk of rupture, 1 due to esthetics in a patient who received a transplant. 39 (95%) could be resolved; the remaining two could not be repaired, one due to infection and the other due to long stenosis after the aneurysm. 22 (55%) patients presented stenosis in some sector after the proximal aneurysm, which suggests that it is a condition for its formation. 19 (45%) patients had no stenosis and can be attributed to arterial hypertension or repeated punctures on the same site. In one case, a prosthesis was interposed for repair, and in the rest plastic was performed with tissues of the same aneurysm. In 2 patients, the AVF was canceled. Fortunately, the rest could be repaired and continue to be used as a definitive vascular access. In 36 (90%) patients it was performed in two stages: a territory is left that allows to continue puncturing the AVF, some are double, joined by a non-dilated segment. The largest one is repaired first, and thus catheter placement is avoided. In patients with stenosis, they were previously repaired, so that the aneurysm does not recur. Aneurysm plastics can be punctured again after 30 to 45 days successfully. It is recommended to repair the AVF aneurysms leaving them functioning. If possible without placement of transient catheter. The risk of aneurysm rupture and the depletion of vascular access in patients is avoided.
Source: Kidney International Reports
Authors: A. VIZCARRA, M. Simon, B. Lococo, R. Paparone, O. Hermida, C. Matomiras, M. Veron
Language: English
Subfield: Emergency Medical Services
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,625
OpenAlex ID: W3010889698