Surgical Management, Prevention and Outcomes for Aneurysms of Arteriovenous Dialysis Fistulas: A Case Series Study and Review.

The escalating population of individuals afflicted with end-stage renal disease necessitates the provision of secure and efficacious vascular access for hemodialysis, with arteriovenous fistulas representing a preferred option. Nonetheless, the creation of dialysis fistulas may entail complications, including the occurrence of fistula aneurysms that may require surgical intervention. This study included eight patients with large aneurysms of dialysis fistulas and aimed to evaluate the safety and effectiveness of classic, endovascular, or hybrid methods for fistula reconstruction or ligation, depending on the indications. Vascular interventions were performed on patients on chronic hemodialysis and on those in whom hemodialysis was discontinued due to the proper functioning of the transplanted kidney. Performed procedures were considered safe and effective. The reconstructed fistulas provided the patients with patent vascular access, allowing for continued hemodialysis. No re-aneurysmal dilatation of the reconstructed or ligated fistulas was observed. Regular monitoring of dialysis fistulas is crucial to detect complications in time. Guidelines should be established to specify the dimensions at which fistula aneurysm should be excised and whether to remove asymptomatic aneurysms at all. For patients who have undergone kidney transplantation, outlines should indicate when the fistula should be preserved and when it should be ligated.

[Varicose veins of lower--how to recognize and treat]. / Zylaki konczyn dolnych--jak rozpoznac i leczyc.

Varicose veins of lower limbs are the most common symptom of chronic venous disorders. They are known for medicine since the Hippocrates time (460-375b.C.), but they were not treated as a serious problem for many years. At present century varicose veins are considered to be not only an esthetic problem, but also a social problem. Scientists from the around world still try to find the best way to treat them. In spite of development the phlebology as a separate science, patients very often don't know where they should ask for help. Usually they are treated by physicians, general practitioners or surgeons. That's why physicians should know very well what to do with patients who suffer from symptoms of chronic venous insufficiency. That's very important also to learn patients, especially with risk factors, how to changed bad habits which promote to development of venous insufficiency and varicose veins. Patients should know how to decrease symptoms of this disease and treat them or how to prevent serious complications.