Mycotic venous aneurysms in cases in autogenous arteriovenous fistulae for chronic haemodialysis

ABSTRACT

Mycotic venous aneurysms are presently met with due to the repeated needling of the autogenous arterio-venous fistulae established for chronic hemodialysis. Twenty-four cases were studied. The average age was 40.3 years. The male to female ratio was 51. The interval form the establishment of the fistula to the mycotic aneurysms was 4.6 months. The fistula was radio-cephalic in 75% of cases and brachio-cephalic in 25% of cases. In two thirds of cases the mycotic aneurysm was near the site of the fistula and distant in the rest. Diagnosis was easy due to the subcutaneous site and peripheral situation along with the repeated examination of this region during hemodialysis Staph. aureus was the responsible organisms in 83.3% of the cases. Patients were treated by dismanteling of the fistula, ligation of the vein together with excision and drainage of the aneurysm and the infected tissues