Brachial artery aneurysm as a late complication of arteriovenous fistula

2021 ◽  
pp. 112972982110593
Author(s):  
Jana Janeckova ◽  
Petr Bachleda ◽  
Marketa Koleckova ◽  
Petr Utikal
Keyword(s):  
Kidney Transplantation ◽  
Arteriovenous Fistula ◽  
Brachial Artery ◽  
Late Complication ◽  
Artery Aneurysm ◽  
Primary Patency ◽  
Arterial Diameter ◽  
Distal Embolization ◽  
Brachial Artery Diameter ◽  
Arteriovenous Fistulas

Introduction: Brachial artery aneurysm (BAA) is a rare late complication of arteriovenous fistula (AVF). It brings the risk of peripheral embolism and hand ischemia and is defined by brachial artery diameter above 10 mm or by regional dilatation by >50%. BAA is described in the literature in closed radiocephalic arteriovenous fistulas after kidney transplantation. The aim of the study was to analyze the prevalence of BAA and of their more dangerous forms. Method: A observational one center study performed on patients after kidney transplantation with AVF or arteriovenous graft (AVG). We invited all patients followed up for kidney transplantation in our center. Arterial diameter greater than 10 mm was considered as a brachial artery aneurysm to simplify the detection and evaluation of aneurysms. Results: About 162 patients with AVF after kidney transplantation were examined between 4/2018 and 4/2020. Brachial artery aneurysm was detected in 34 patients (21%) with AVF or AVG, of them 7 had confirmed wall thrombi. AVF flow volume of more than 1500 ml/min increased the risk of BAA development by 4.54x. Eight aneurysms were treated surgically. After this surgery, the primary patency was 87.5% in 12 months. Conclusion: Brachial artery aneurysm was relatively frequent in our study compare to the literature. Aneurysm or dilatation of the brachial artery is more frequent in functional AVFs. Surgical correction is necessary in cases of complicated aneurysms to prevent distal embolization.

Giant brachial artery aneurysm as a rare complication of a dialysis shunt

2019 ◽  
Vol 21 (5) ◽  
pp. 799-802 ◽  
Author(s):  
Elisa Maria Schilling ◽  
Malte Weinrich ◽  
Thomas Heller ◽  
Sebastian Koball ◽  
Andreas Neumann
Keyword(s):  
Brachial Artery ◽  
Rare Complication ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Magnetic Resonance Imaging Scan ◽  
Dialysis Access ◽  
Large Tumor ◽  
Arteriovenous Fistulas ◽  
Arteriovenous Shunts ◽  
Ongoing Care

Our patient exhibited a large tumor on his right upper arm where his former dialysis access site had been. X-ray, Doppler ultrasound, and magnetic resonance imaging scan could not fully reveal the nature of that tumor. Eventually, a surgical approach showed a giant aneurysm of the inflowing brachial artery to a partially obliterated arteriovenous fistula. This case highlights the importance of ongoing care for patients with arteriovenous shunts. Even arteriovenous fistulas, that are obliterated or no longer in use, can, especially when immunosuppressant therapy and other vascular risk factors are added to the overall cardiovascular risk, transform and endanger the health of our patients.

Outcomes of radiocephalic fistula created by nephrologists

2019 ◽  
Vol 20 (6) ◽  
pp. 615-620
Author(s):  
Narayan Prasad ◽  
Venkatesh Thammishetti ◽  
DS Bhadauria ◽  
Anupama Kaul ◽  
RK Sharma ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Care Center ◽  
Tertiary Care ◽  
Primary Patency ◽  
North India ◽  
Maintenance Hemodialysis ◽  
Secondary Patency ◽  
Arteriovenous Fistulas ◽  
Secondary Failure ◽  
Stage Renal Disease

Introduction: Arteriovenous fistula is considered as gold standard access for maintenance hemodialysis. Due to increasing burden of end-stage renal disease requiring dialysis, it is important for nephrologists to complement creation of arteriovenous fistula to meet the demand. Methods: This retrospective study was designed to assess the outcomes of arteriovenous fistula made by nephrologists at a tertiary care center from North India. The study included all radiocephalic arteriovenous fistula performed by nephrologists between November 2015 and January 2017. All arteriovenous fistulas were performed in patients whose duplex ultrasonography revealed both arterial and venous diameter of at least 2 mm. Data were collected with regard to age, gender, dialysis status, basic diseases, co-morbidities, and mineral bone disease parameters. The predictors of the primary and secondary patency rates were analyzed. Results: Five hundred patients (age 39.3 ± 14.4 years; 82.4% males; 21.6% diabetics) were included. In total, 83 (16.6%) patients had primary failure and 31 (7%) patients had secondary failure. Diabetes was associated with poor primary and secondary patency rates. Mean survival among the patients without primary failure was 11 months. The primary patency rates at 3, 6, 12, 18, and 21 months were 82%, 78%, 73%, 70%, and 70%, respectively. Conclusion: To conclude, the outcomes of radiocephalic arteriovenous fistulas created by nephrologists are at par with historic outcomes.

Late Occurrence of a Large Brachial Artery Aneurysm following Closure of a Hemodialysis Arteriovenous Fistula

2006 ◽  
Vol 20 (4) ◽  
pp. 533-535 ◽  
Author(s):  
Luciano Battaglia ◽  
Federico Bucci ◽  
Mario Battaglia ◽  
Adriano Reddler
Keyword(s):  
Arteriovenous Fistula ◽  
Brachial Artery ◽  
Artery Aneurysm ◽  
Hemodialysis Arteriovenous Fistula

True Brachial Artery Aneurysm after Arteriovenous Fistula for Hemodialysis: Five Cases and Literature Review

2017 ◽  
Vol 39 ◽  
pp. 228-235 ◽  
Author(s):  
Jihene Fendri ◽  
Laura Palcau ◽  
Lucie Cameliere ◽  
Olivier Coffin ◽  
Aurelien Felisaz ◽  
...  
Keyword(s):  
Literature Review ◽  
Arteriovenous Fistula ◽  
Brachial Artery ◽  
Artery Aneurysm

Neurovascular compromise due to true brachial artery aneurysm at the site of a previously ligated arteriovenous fistula: Case report and review of literature

Vascular ◽  
2015 ◽  
Vol 23 (6) ◽  
pp. 668-672 ◽  
Author(s):  
Emily C Cleveland ◽  
Sammy Sinno ◽  
Sharvil Sheth ◽  
Sheel Sharma ◽  
Firas F Mussa
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Upper Extremity ◽  
Brachial Artery ◽  
Relevant Literature ◽  
Artery Aneurysm ◽  
Review Of Literature ◽  
Vascular Compromise ◽  
Arterial Aneurysms ◽  
Median Neuropathy

True arterial aneurysms of the upper extremity are rare. The case described is that of a 48-year-old man presenting with median neuropathy and distal vascular compromise 4 years after ligation of a brachiocephalic arteriovenous fistula. We describe our approach and present a review of the relevant literature.

The Effect of Chronic Flow Changes on Brachial Artery Diameter and Shear Stress in Arteriovenous Fistulas for Hemodialysis

2002 ◽  
Vol 25 (2) ◽  
pp. 124-128 ◽  
Author(s):  
R. Dammers ◽  
J.H.M. Tordoir ◽  
R. J.T.H.J. Welten ◽  
P. J.E.H.M Kitslaar ◽  
A.P.G. Hoeks
Keyword(s):  
Shear Stress ◽  
Brachial Artery ◽  
Vessel Diameter ◽  
Brachial Artery Diameter ◽  
Arteriovenous Fistulas ◽  
Sustained Effects ◽  
Hemodialysis Vascular Access ◽  
Acute Increase ◽  
Flow Changes ◽  
One Year

Background Vessel wall adaptation to acute or chronic flow changes is regulated by shear stress (SS) at the endothelium. This hypothesis was tested in the brachial artery (BA) of patients receiving an arteriovenous fistula (AVF) for hemodialysis vascular access. Methods The acute and sustained effects were evaluated in 13 patients. Pre-operatively and postoperatively on predetermined time-points BA diameter and shear rate (SR) were measured. SS was calculated from whole blood viscosity and SR. Analysis was performed with Wilcoxon's test and ANCOVA multivariate analysis. Results Acutely, mean SS increased (475%, p<0.05), peak-to-peak SS decreased (37%, p<0.05) and peak SS remained constant. BA diameter increased (15%, p<0.05). After one year a further increase was observed (r=0.59, p<0.001), plus an increase in mean SS (r=0.78, p<0.001). Peak-to-peak SS remained constant. Conclusion Our results indicate that after AVF placement an acute increase in SS results in an acute increase of vessel diameter. However, one year of sustained high blood flow does not result in restoration of mean SS.

Brachial Artery Aneurysm Following Open Repair of Posttraumatic False Aneurysm and Arteriovenous Fistula

2010 ◽  
Vol 44 (8) ◽  
pp. 691-692 ◽  
Author(s):  
Stephen O'Neill ◽  
Mark E. O'Donnell ◽  
Anton Collins ◽  
Denis W. Harkin
Keyword(s):  
Arteriovenous Fistula ◽  
Brachial Artery ◽  
False Aneurysm ◽  
Open Repair ◽  
Artery Aneurysm

scholarly journals Comparison of pharmacomechanical and surgical interventions for thrombosed native arteriovenous fistulas

2020 ◽  
Vol 28 (4) ◽  
pp. 609-614
Author(s):  
Ebuzer Aydın
Keyword(s):  
Treatment Group ◽  
Arteriovenous Fistula ◽  
Failure Rate ◽  
Patency Rate ◽  
Primary Patency ◽  
Primary Patency Rate ◽  
Surgical Interventions ◽  
Arteriovenous Fistulas ◽  
Surgical Thrombectomy ◽  
Surgical Group

Background: This study aims to compare success and patency rates of pharmacomechanical thrombectomy versus open surgical thrombectomy for thrombosed native arteriovenous fistulas. Methods: A total of 96 patients (56 males, 40 females; mean age 61±11.7 years; range, 26 to 82 years) with a thrombosed native arteriovenous fistula between January 2016 and December 2018 were retrospectively analyzed. The patients were divided into two groups as pharmacomechanical thrombectomy (n=42) and open surgical thrombectomy (n=54). Primary failure rate and primary patency rate at 6 and 12 months were recorded. Results: Of 42 patients in the pharmacomechanical thrombectomy group, 41 (98%) had additional interventions, and primary failure occurred in four patients (10%). Primary failure was seen in 15 (28%) patients in the surgical group. The primary patency rates at 6 and 12 months were significantly higher in the pharmacomechanical treatment group than the surgical group (85% vs. 67% and 78% vs. 55%, respectively; p<0.05). Conclusion: Pharmacomechanical thrombectomy procedure yields higher primary patency rates than open surgical thrombectomy for thrombosed native arteriovenous fistula.

Intraoperative pneumatic tourniquet use may improve the clinical outcomes of arteriovenous fistula creations

2019 ◽  
Vol 20 (6) ◽  
pp. 706-715
Author(s):  
Shouwen Wang ◽  
Michele S Wang
Keyword(s):  
Arteriovenous Fistula ◽  
Clinical Outcomes ◽  
Patency Rate ◽  
Proportional Hazards ◽  
Primary Patency ◽  
Cox Proportional Hazards ◽  
Lead Author ◽  
Primary Patency Rate ◽  
Pneumatic Tourniquet ◽  
Arteriovenous Fistulas

Objectives: A major pathology affecting the usability of arteriovenous fistulas for hemodialysis is juxta-anastomosis stenosis. Intraoperative pneumatic tourniquet eliminates the use of vascular clamps, reduces vascular trauma, and may then reduce the juxta-anastomosis stenosis. The aim of this study was to compare the outcomes of arteriovenous fistula creations using the tourniquet-assisted approach versus the clamp-assisted approach. Methods: This retrospective study analyzed the outcomes of primary arteriovenous fistulas created by the lead author from 2008 to 2017 and met the specified inclusion criteria applied to both groups. Results: A total of 575 patients were included. Upon comparing the tourniquet group ( n = 411) with the clamp group ( n = 164): the primary arteriovenous fistula failure rate was significantly lower (2.4% vs 7.3%, p = 0.01); the percentage of arteriovenous fistula used for hemodialysis without initial interventions was significantly higher (71.5% vs 45.1%, p < 0.001) and with initial interventions was conversely lower (26.0% vs 47.6%, p < 0.001); the primary patency rate of the whole fistula conduits was significantly higher (44.2% vs 23.0% at 1 year, p < 0.001) and so was the cumulative patency rate (97.2% vs 92.6% at 1 year, p < 0.001); and the juxta-anastomosis primary patency rate (free of interventions for the juxta-anastomosis region) was higher (71.0% vs 47.8% at 1 year, p < 0.001). Based on multivariate Cox proportional hazards regression analyses, the effect of tourniquet use on the juxta-anastomosis primary patency remained significant (hazard ratio = 2.24, 95% confidence interval = 1.72–2.93, p < 0.001) when other significant factors (fistula location, gender, and diabetes) were considered. Conclusion: Intraoperative pneumatic tourniquet may significantly improve the clinical outcomes of arteriovenous fistula creations by reducing juxta-anastomosis trauma and subsequent stenosis.

scholarly journals A Rare Case of Brachial Artery Aneurysm Following Hemodialysis Fistula Ligation in a Transplanted Patient

2018 ◽  
Vol 53 (1) ◽  
pp. 71-74
Author(s):  
Christiana Anastasiadou ◽  
Angelos Megalopoulos ◽  
Karmen Tasiopoulou ◽  
Vasileios Intzos
Keyword(s):  
Arteriovenous Fistula ◽  
Brachial Artery ◽  
Rare Case ◽  
Artery Aneurysm ◽  
Cephalic Vein ◽  
Hemodialysis Fistula ◽  
Pathophysiologic Mechanisms

Aneurysmal arterial dilatation is an infrequent complication following arteriovenous fistula ligation. Herein, we are describing a case in which a 49-year-old transplanted patient developed a true, symptomatic, brachial artery aneurysm 25 years after transplantation and 12 years after ligation of his radiocephalic wrist fistula. Treating strategy included aneurysmectomy and reversed vein interposition using ipsilateral, dilated branch of cephalic vein. Two years postoperatively, the patient remains without complications. Moreover, we mention the pathophysiologic mechanisms that may have contributed to this phenomenon.

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