Page 16 - Virtual Vascular Vol 3
P. 16

A














          Reduction aneurysmorrhaphy                                                 Postop Day 7









       The inflow and outflow of aneurysm was clamped and was then open longitudinally.
       The infected anterior wall was excised. All intraluminal thrombus was evacuated.                                             Aneurysm developed in an AV fistula
       Since the AV fistula is the life-line of the patient and preservation of the
       haemodialysis vascular access is very important. We decided to performed reduction                                           created for haemodialysis

       aneurysmorrhaphy, excision part of the aneurysmal wall and closed the aneurysm by
       4/0 Prolene suture. The circuit of the AV fistula is maintained. Together with IV
       antibiotics, the infection is well control, and the AV fistula is ready to be needled                                        • Formed due to repeated puncture during HD that

       again on post-op Day 7. The left femoral catheter can be removed once smooth                                                    weakens the vein wall
       dialysis is achieved via the AV fistula.
                                                                                                                                    • Differential diagnosis of aneurysm formation due to

                                                                                                                                       outflow venous obstruction
        16                                                                                                                                                                                                                            17
   11   12   13   14   15   16   17   18   19   20   21