RESUMO
Background: Arterio-venous fistula [AVF] provides the best functional patency for patients on regular hemodialysis [HD]. Nevertheless, complications such as AVF aneurysms, steal syndrome, venous hypertension and infections are not uncommon
Objective: To evaluate the trends in AVF aneurysm formations, prophylaxis and treatment options
Design: A Retrospective, Descriptive Study
Setting: Hemodialysis Centers, Ministry of Health, Kingdom of Bahrain
Method: Two hundred and eleven patients on hemodialysis via arterio-venous fistula and arteriovenous graft were included in the study
Result: Two hundred and eleven patients were on hemodialysis via arterio-venous fistula and arterio-venous graft. Thirty [14.22%] patients developed arterio-venous fistula aneurysm. Sixteen [53.33%] were males, and the mean age was 57 years. Eleven [36.66%] patients had excision of the aneurysms with interposition graft. Six [20%] patients had excision of the aneurysms with new fistula formation. Six [20%] patients required a change of the cannula insertion site while the remaining 7 [23.33%] patients were waiting for their scheduled date of surgery
Conclusion: Aneurysm formation is the most common complication in post AVF patients on regular HD. AVF aneurysms are at high risk of rupture and fatal hemorrhage. Surgical treatments could safely be performed for high risk aneurysms. The most common cause of aneurysm formation is repeated punctures at the same site
RESUMO
A case of thyroid carcinoma occurring in a thyrotoxic patient is presented. The diagnosis was made after surgery. Our surgical policy in thyrotoxicosis is near-total thyroidectomy, the aim being to reduce the incidence of recurrence. The patient is alive and well and has no detectable recurrence or metastasis three years after operation