| Aneurysmal degeneration of the donor artery after vascular access. | |
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MedLine Citation:
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PMID: 22322118 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: This retrospective study analyzed the characteristics, potential risks, and therapeutic options of true aneurysms of the donor artery in arteriovenous fistulas (AVFs) for dialysis access. METHODS: We retrospectively collected data of patients with aneurysmal degeneration (AD) after AVF creation from surgeons who were members of the French Society for Vascular Access, treated from January 2006 to May 2011. The study excluded patients with pseudoaneurysms. Patient demographics, type of access, aneurysm characteristics, symptoms, treatment, and follow-up were recorded. RESULTS: Seven men and three women (mean age, 38.1 ± 5.3 years) were identified with AD (mean diameter, 44.5; range, 24-80 mm) Mean duration of access was 83.6 ± 48.8 months. Diagnosis of AD was at 117.5 ± 53.8 months after access creation. The initial access was radiocephalic, six; ulnobasilic, one; brachiocephalic, two; and brachiobasilic, one. Three patients had two successive accesses: one brachioaxillary polytetrafluoroethylene (PTFE) graft and two proximalizations of a failed radiocephalic AVF. Symptoms were pain and swelling, four; pain related to total thrombosis without signs of ischemia, two; median nerve compression, two; pain related to contained rupture, one; and subacute ischemia due to embolic occlusion of both radial and interosseous arteries, one. AD location was brachial, seven; axillary, one; radial, one; and ulnar, one. Eight patients underwent surgical aneurysm excision associated with interposition bypass using great saphenous vein, two; basilic vein, one; PTFE, three; Dacron, one; and allograft, one. Two patients needed secondary PTFE bypass because of progression of AD to the inflow artery and dilatation of the venous bypass. With a mean follow-up of 20.3 ± 17 months, all bypasses but one remained patent. CONCLUSIONS: AD is a rare but significant complication of vascular access. Surgical correction should be discussed in most cases due to potential complications. After resection, the choice of reconstructive conduit is not straightforward. |
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Authors:
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Jean Marzelle; Valbon Gashi; Hong-Duyen Nguyen; Albert Mouton; Jean-Pierre Becquemin; Pierre Bourquelot |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-7 |
Journal Detail:
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Title: Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter Volume: - ISSN: 1097-6809 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Vascular Surgery, Henri Mondor University Hospital (Paris XII), Créteil, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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