ES Factors contributing to patency after aneurysmorrhaphy and outflow repair in arteriovenous fistula aneurysm treatment

Executive Summary

Factors contributing to patency after aneurysmorrhaphy and outflow repair in arteriovenous fistula aneurysm treatment

Ismazizi Zaharudin

Sunil Siri Pathamanathan, Nurul Nadiah Nazurah Binti Mohd Ali, Muhammad Zaid Haritha Mohamed Fauzi, Ismazizi Zaharudin.

Published: Med J Malaysia. 2024 May;79(3):245-250

Background

This study looked at a common problem in people who are on long-term dialysis because of kidney failure. These patients often have a special connection made between an artery and a vein in their arm called an arteriovenous fistula (AVF), which allows easy access for dialysis. Over time, some of these fistulas can develop bulges, known as aneurysms, which can be dangerous if not treated. The goal of the study was to see how effective it is to repair these bulges and what factors help the repairs last.

Key Findings:

 

Participants

  • The study followed 64 patients, mostly men, with an average age of 45. Each of them had a bulging area in their AVF that needed to be fixed.

 

Procedure

  • All patients had surgery to repair the bulging area. If their blood vessels also had any blockages, doctors treated those at the same time. One common method used in the repairs was called aneurysmorrhaphy, a technique to reshape or remove the bulge.

 

Monitoring

  • The patients were monitored for one year after the procedure to see if the repaired fistulas kept working properly.

 

Results:

Success Roles

  • After one year, 86% of the repaired fistulas were still working without needing more surgery, and 95% were still usable even if some extra help was needed along the way.

Better Outcomes

  • The repairs worked best in younger patients and in those who already had strong blood flow through their fistulas before the procedure.

 

Complications

  • A few patients developed new blockages later, but these were treatable. Serious problems were rare, and most repairs held up well over time.

 

Conclusion

Fixing aneurysms in dialysis access points generally works well, especially when doctors also fix any blood flow problems at the same time. Younger patients and those with better initial blood flow tend to have the best results. Regular checkups are important so any new issues can be caught early and taken care of before they get worse.