PDF(Pubmed)
Abstract：
BACKGROUND: Arteriovenous fistula stenosis can directly lead to the formation of autologous arteriovenous fistula aneurysms (AVFAs), but the coexistence of true and pseudoaneurysms is relatively rare. The coexistence of true and pseudoaneurysms increases the risk of rupture of the arteriovenous fistula and complicates subsequent surgical intervention, potentially posing a threat to the patient\'s life, and thus requires significant attention.
METHODS: The patient presented with arteriovenous fistula (AVF) after hemodialysis 6 years ago. 2 years ago, the patient presented with a mass that had formed near the left forearm arteriovenous fistula and gradually increased in size. Preoperatively, the AVF stenosis was identified as the cause of the mass formation, and the patient was operated on. First, the blood flow was controlled to reduce the pressure at the aneurysm, and then the incision was enlarged to separate the AVF anastomosis from the mass area. The stenotic segment of the true and pseudo aneurysms and cephalic vein was removed and the over-dilated proximal cephalic vein was locally narrowed and subsequently anastomosed with the proximal radial artery to create AVF. The patient was dialyzed with an internal fistula the next day and showed no clinical manifestations related to end-limb ischemia.
CONCLUSIONS: We removed a true pseudoaneurysm in AVF and secured the patient\'s vascular access. This report provides an effective strategy to manage this condition.
METHODS: The patient presented with arteriovenous fistula (AVF) after hemodialysis 6 years ago. 2 years ago, the patient presented with a mass that had formed near the left forearm arteriovenous fistula and gradually increased in size. Preoperatively, the AVF stenosis was identified as the cause of the mass formation, and the patient was operated on. First, the blood flow was controlled to reduce the pressure at the aneurysm, and then the incision was enlarged to separate the AVF anastomosis from the mass area. The stenotic segment of the true and pseudo aneurysms and cephalic vein was removed and the over-dilated proximal cephalic vein was locally narrowed and subsequently anastomosed with the proximal radial artery to create AVF. The patient was dialyzed with an internal fistula the next day and showed no clinical manifestations related to end-limb ischemia.
CONCLUSIONS: We removed a true pseudoaneurysm in AVF and secured the patient\'s vascular access. This report provides an effective strategy to manage this condition.
摘要：
背景：动静脉瘘狭窄可直接导致自体动静脉瘘动脉瘤（AVFA）的形成，但是真实和假性动脉瘤的共存相对较少。真实动脉瘤和假性动脉瘤的共存增加了动静脉瘘破裂的风险，并使随后的手术干预复杂化。可能对病人的生命构成威胁，因此需要大量的关注。
方法：患者6年前在血液透析后出现动静脉内瘘（AVF）。两年前,患者出现了一个肿块，该肿块在左前臂动静脉瘘附近形成，并逐渐增大。术前,AVF狭窄被确定为肿块形成的原因，病人接受了手术。首先,控制血流以降低动脉瘤处的压力,然后扩大切口，将AVF吻合术与肿块区分开。切除真假动脉瘤和头静脉的狭窄段，并将过度扩张的近端头静脉局部变窄，随后与近端桡动脉吻合以产生AVF。患者第二天进行了内瘘透析，未出现与肢体末端缺血相关的临床表现。
结论：我们切除了一个真实的AVF假性动脉瘤，并确保了患者的血管通路。本报告提供了管理这种情况的有效策略。
方法：患者6年前在血液透析后出现动静脉内瘘（AVF）。两年前,患者出现了一个肿块，该肿块在左前臂动静脉瘘附近形成，并逐渐增大。术前,AVF狭窄被确定为肿块形成的原因，病人接受了手术。首先,控制血流以降低动脉瘤处的压力,然后扩大切口，将AVF吻合术与肿块区分开。切除真假动脉瘤和头静脉的狭窄段，并将过度扩张的近端头静脉局部变窄，随后与近端桡动脉吻合以产生AVF。患者第二天进行了内瘘透析，未出现与肢体末端缺血相关的临床表现。
结论：我们切除了一个真实的AVF假性动脉瘤，并确保了患者的血管通路。本报告提供了管理这种情况的有效策略。
