PHÌNH TO CẦU NỐI ĐỘNG TĨNH MẠCH Ở NGƯỜI BỆNH  ĐANG CHẠY THẬN NHÂN TẠO: PHẪU THUẬT TÁI TẠO  MỘT TRƯỜNG HỢP VÀ HỒI CỨU Y VĂN

Phước Trần Hữu; Đức Tiêu Chí

doi:10.59354/ydth175.2025.374

Keywords:

arteriovenous fistula, hemodialysis, aneurysm, surgical reconstruction

Abstract

Background: Aneurysm of the arteriovenous fistula (AVF) is a serious complication frequently observed in long-term hemodialysis patients. If not treated promptly, this complication may lead to rupture of the fistula, posing a life-threatening risk. This article presents a clinical case involving the surgical reconstruction of an aneurysmal arteriovenous fistula and a literature review on the management of AVF aneurysms.

Case Report: A 42-year-old female patient with a history of end-stage renal disease has been undergoing hemodialysis via an arteriovenous fistula in her right forearm for 13 years. The patient presented with symptoms of pain and aneurysmal enlargement at the needle puncture sites of the fistula. Upon clinical examination and imaging, we identified a high risk of fistula rupture and decided to perform surgical reconstruction. The surgery was successfully completed, and the patient recovered well within 4 weeks.

Conclusion: Surgical reconstruction of an arteriovenous fistula is an effective method for treating AVF aneurysms in hemodialysis patients, helping to preserve fistula function and prevent life-threatening complications.

References

Shahri J. J., Saberianpour S., Kazemzadeh G., (2022), Arteriovenous Fistula Aneurysm: Bench to Bedside, Indian Journal of Surgery, 85 (S1), 219-227.

Balaz P., Rokosny S., Bafrnec J., et al, (2020), Repair of Aneurysmal Arteriovenous Fistulae: A Systematic Review and Meta-analysis, Eur J Vasc Endovasc Surg, 59 (4), 614-623.

Ellingson K. D., Palekar R. S., Lucero C. A., et al, (2012), Vascular access hemorrhages contribute to deaths among hemodialysis patients, Kidney Int, 82 (6), 686-692.

Inston N., Mistry H., Gilbert J., et al, (2017), Aneurysms in vascular access: state of the art and future developments, J Vasc Access, 18 (6), 464-472.

Asif A., Leon C., Orozco-Vargas L. C., et al, (2007), Accuracy of physical examination in the detection of arteriovenous fistula stenosis, Clin J Am Soc Nephrol, 2 (6), 1191-1194.

Lok C. E., Huber T. S., Lee T., et al, (2020), KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update, Am J Kidney Dis, 75 (4 Suppl 2), S1-S164.

Balaz P., Bjorck M., (2015), True aneurysm in autologous hemodialysis f istulae: definitions, classification and indications for treatment, J Vasc Access, 16 (6), 446-453.

Sidawy A. N., Spergel L. M., Besarab A., et al, (2008), The Society for Vascular Surgery: clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access, J Vasc Surg, 48 (5 Suppl), 2S-25S.

Rooijens P. P., Burgmans J. P., Yo T. I., et al, (2005), Autogenous radial-cephalic or prosthetic brachial-antecubital forearm loop AVF in patients with compromised vessels? A randomized, multicenter study of the patency of primary hemodialysis access, J Vasc Surg, 42 (3), 481-486; discussions 487.