• Vol. 36 No. 10, 851–853
  • 15 October 2007

Arteriovenous Fistula Aneurysm – Plicate, Not Ligate



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Introduction: Arteriovenous fistula (AVF) created for haemodialysis can be complicated by aneurysm formation. Clinical Picture: Ligation of the fistula is often required to prevent aneurysmal rupture and the life-threatening haemorrhage that ensues. Other methods of treatment involve using foreign bodies like mesh and grafts. Treatment: We describe a new method in the treatment of this condition – plication. It involves plicating the excess free wall of the aneurysm with sutures and does not require resection or anastomosis. Outcome: Early results show that this method shrinks the aneurysm size and reduces the risk of haemorrhage. Conclusion: The AVF can continue to be used and the patient is spared the agony of having to go through the entire cycle of creating a new vascular access site.

Arteriovenous fistulae (AVF) are created for haemodialysis in patients with end-stage renal failure. While AVF is a lifeline for these patients, its creation is not without complications.1 One complication is that of aneurysmal dilatation, which can cause rupture and potentially fatal haemorrhage.

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