Surgical treatment of venous aneurysms developing in arteriovenous fistulae in hemodialysis patients

Background: In this study, we investigated the results of the surgical treatment of the aneurysms before any complications develop in dialysis patients in whom arteriovenous fistula aneurysm has detected and the long term utilization of their fistulae. Methods: Eighteen patients (7 males, 11 females; mean age 47.5 years; range 32 to 75 years) in whom aneurysms of 4 cm or over developed and who were operated on for the purpose of hemodialysis in the Department of Cardiovascular Surgery in Trabzon Numune Training and Research Hospital between September 2003 and February 2009, were evaluated retrospectively. In 11 cases radiocephalic and in seven cases brachiocephalic arteriovenous fistula were explored. Surgical methods were determined during surgery by taking the structure of the patient's artery and vein into account. Results: All patients were discharged within the first 24 hours after surgery. After the procedure no complications such as surgical wound infection, hematoma, neurological damage, ischemia were observed. The mean follow-up after the resection was 39 months (range; 7-56 months). Conclusion: Arteriovenous fistula aneurysms should be treated before any complications develop. Surgical repair still remains the gold standard. We believe that narrowing the aneurysmal sac, instead of ligation, is a safe surgical technique that allows the continuity of the fistula.