Emergency brachial artery ligation for ruptured infected pseudoaneurysm of haemodialysis access is a possible option
| Autor: | Arfan Nasser, Harshil Joshi, Ravindra Prabhu, Vijay Kumar, Rajkamal Vishnu, Guruprasad Rai, Ganesh S Kamath, Lalu Prasad Soni, Arvind Kumar Bishnoi |
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| Rok vydání: | 2018 |
| Předmět: |
Nephrology
Adult Male medicine.medical_specialty Time Factors Brachial Artery 030232 urology & nephrology Vascular access Arteriovenous fistula 030204 cardiovascular system & hematology Aneurysm Ruptured Upper Extremity 03 medical and health sciences Pseudoaneurysm Young Adult 0302 clinical medicine Arteriovenous Shunt Surgical Renal Dialysis Risk Factors Internal medicine medicine.artery medicine Humans Brachial artery Ligation Aged Retrospective Studies business.industry Retrospective cohort study Middle Aged medicine.disease Surgery Treatment Outcome Kidney Failure Chronic Female Emergencies Complication business Aneurysm Infected Aneurysm False |
| Zdroj: | The journal of vascular access. 20(5) |
| ISSN: | 1724-6032 |
| Popis: | Background: For patients with end-stage renal disease, a good vascular access is essential for chronic haemodialysis. Surgically created access arteriovenous fistula for haemodialysis is associated with multiple complications, and ruptured pseudoaneurysm being the most life threatening and dreaded of all. The management of this complication warrants emergency procedure, although timely diagnosis and arteriovenous fistula salvage has been emphasised. In this study, we describe the surgical technique and outcomes of ligation of the proximal arteriovenous fistula as a plausible alternative and life-saving procedure. Method and Results: This is a retrospective study performed between January 2011 and December 2016. A total of 588 native arteriovenous fistula–related surgeries were performed, of which 18 patients (3.06%) developed delayed complication of infected pseudoaneurysm and rupture. All presented to the emergency care with life-threatening bleeding. We describe the surgical technique as a life-saving measure to this fatal complication. Conclusion: Proximal arteriovenous fistula has higher incidence of aneurysmal complications than distal ones. Ligation of the brachial artery which was a ‘grey zone’ of unpredictable prognosis has yielded good results and can be safely performed in desperate situations with low complication rates. |
| Databáze: | OpenAIRE |
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