Arteriovenous fistulas (AVFs) are surgical connections between an artery and vein that are necessary for individuals who require hemodialysis. However, aneurysms can form within AVFs, causing them to fail and ultimately necessitating their repair. While endovascular repair is a minimally invasive procedure used for many AVF repairs, open revision is considered the recommended approach for repairing AVF aneurysms.
Yale investigators have reported a case series detailing a hybrid approach to AVF aneurysm repair for cases in which initial attempts for endovascular repair were unsuccessful. They found that initial imaging of the vasculature using endovascular procedures before open revision allows for a better assessment of irregularities in the AVF vasculature. Furthermore, AVF aneurysms can cause complications such as the formation of clots within the aneurysm which make a complete endovascular repair difficult.
While they highlight the success of this hybrid approach in this case series, they also note that a further evaluation with long-term follow-up is required to better assess the benefit compared to existing approaches for AVF aneurysm repair.
To learn more, read the publication: Hybrid Revision of Dysfunctional Aneurysmal Arteriovenous Fistulas
Kostiuk, V., Chen, J. F., Dahl, N. K., Turner, J. M., & Ochoa, I. (2023). Hybrid Revision of Dysfunctional Aneurysmal Arteriovenous Fistulas. Vascular and Endovascular Surgery, 57(8), 909–913. https://doi.org/10.1177/15385744231183488