Balloon Plasty of Pseudoaneurysm of AV Fistula in CKD.

ABSTRACT

Arteriovenous fistula is a procedure done for long-term haemodialysis in patients with end stage renal failure. Aneurysms are a common and often difficult complication seen with arterio venous vascular access for haemodialysis. In this case report we describe middle aged male patient who was a known case of chronic kidney disease on maintenance haemodialysis through left arm brachio-basilic AV fistula and had developed a pseudo aneurysm of the AVF. We performed an Endovascular intervention for salvaging haemodialysis AV fistula in which balloon plasty was done and flow was obtained. To ensure adequate haemodialysis treatments, a well-functioning vascular access (VA) is a prerequisite in dialysis patients. Arteriovenous fistula (AVF) has become a long-term haemodialysis treatment in patients with renal failure in the end stage and this has not changed until now.(1) For long-term haemodialysis with low morbidity levels, arteriovenous fistula should provide a convenient repeated vascular access line. The development of aneurysm may occur due to frequent punctures that in some patients may weaken the vein wall. Proximal stenosis often speeds up the process by increasing the pressure in the AVF.(2) Such patients may have a large, painful aneurysm sac, which can lead to dermal tissue necrosis. It may become compromised as a result of vascular or traumatic events. The aneurysm sac can split, which may result in fatal haemorrhage.