Arterovenous Fistula's Pseudoaneurysm Percutaneous Treatment: A Case Report

Abstract

Pseudoaneurysm is a frequent complication of vascular accesses. The following case report highlights diagnosis and treatment of left distal artero-venous fistula pseudoaneurysm, located 3–4 cm above the anastomosis of the efferent vein. Pseudoaneurysm exerted a compressive effect on the mood with consequent blood flow reduction during hemodialysis sessions. Doppler ultrasound evaluation showed a reduction in blood flow rate calculated at the brachial artery level (2–3 cm from the elbow). Pseudoaneurysm was treated in the angiography room through percutaneous endovascular technique (PTA) and the interposition of a covered stent to exclude it. The angiography showed a pre-anastomotic stenosis of the radial artery that had not been detected by ECD; an angioplasty was performed. After the procedure, the angiographic examination of the AVF showed a complete perfusion, while Doppler ultrasound confirmed an adequate blood flow for the hemodialysis session.