Stent graft treatment for hemodialysis access aneurysms

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Presentation transcript:

Stent graft treatment for hemodialysis access aneurysms David Shemesh, MD, Ilya Goldin, MD, Ibrahim Zaghal, MD, Daniel Berelowitz, MB, BChir, Anthony G. Verstandig, MB, BS, Oded Olsha, MB, BS Journal of Vascular Surgery Volume 54, Issue 4, Pages 1088-1094 (October 2011) DOI: 10.1016/j.jvs.2011.03.252 Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 1 A 75-year-old woman with brachial cephalic autogenous access with acute puncture site bleeding referred from another hospital for urgent treatment. The aneurysm with overlying eschar through which the patient bled is clearly visible. Journal of Vascular Surgery 2011 54, 1088-1094DOI: (10.1016/j.jvs.2011.03.252) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 2 Kaplan-Meier curve for endovascular exclusion of complicated access aneurysms. Functional patency at twelve months was 87%. AVA, Arteriovenous access; SE, standard error. Journal of Vascular Surgery 2011 54, 1088-1094DOI: (10.1016/j.jvs.2011.03.252) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 3 A Fluency stent graft was used to exclude a brachial axillary graft pseudoaneurysm 3 years earlier and was used for hemodialysis access puncture since that time. During angioplasty for central vein stenosis, the broken Nitinol skeleton at the puncture site can be seen near the arterial end of the stent graft (A), and there is a small false aneurysm at the site of the break in the stent graft (B). Journal of Vascular Surgery 2011 54, 1088-1094DOI: (10.1016/j.jvs.2011.03.252) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 4 A brachial axillary graft pseudoaneurysm was stented with a Hemobahn stent graft. The remaining 4.5 cm pseudoaneurysm sac (A), interefered with available puncture sites. The organized thrombus was removed (B), and the sac (C), was excised leaving the underlying stent graft exposed (D). The overlying skin was closed in two layers (E). Journal of Vascular Surgery 2011 54, 1088-1094DOI: (10.1016/j.jvs.2011.03.252) Copyright © 2011 Society for Vascular Surgery Terms and Conditions