Authors
Marco Franchin, Federico Villa, Laura Ros, Luca Biancalana, Maria Cristina Cervarolo, Francesca Mauri, Gabriele Piffaretti, Matteo Tozzi
Published in
The journal of vascular access. Pages 11297298251349471. Jul 06, 2025. Epub Jul 06, 2025.
Abstract
Aneurysmal degeneration of autogenous arteriovenous fistulas represents an increasingly prevalent complication in long-term dialysis patients, often leading to access failure and significant morbidity. Despite the clinical relevance, consensus on optimal surgical management remains limited.
We present a 10-year single-center experience with a modified stapling technique for AVF aneurysmoplasty, aimed at preserving native access while enabling immediate post-operative cannulation. This retrospective analysis includes 184 patients undergoing reconstruction for AVF aneurysms between 2014 and 2024.
Technical success was achieved in 95.7% of cases, with early cannulation feasible in 91.6% of patients. The early failure rate was 2.3%. Primary patency at 1, 3, 5, and 10 years was 91.3%, 87.8%, 80.8%, and 22.6%, respectively; cumulative functional patency was 94%, 91.1%, 83.6%, and 30.5%. Recurrence was observed in 15.2% of cases, strongly associated with high-flow AVFs and central venous stenosis. Targeted intraoperative flow improved outcomes in anatomically complex cases.
Stapled aneurysmoplasty is a safe and durable option for AVF reconstruction, with high success and patency rates. Preoperative flow assessment and individualized hemodynamic correction are crucial to long-term outcomes. In cases of recurrence, conversion to graft-based access may be warranted. These findings support a native access-preserving approach in suitable patients.
PMID:
40618244
Bibliographic data and abstract were imported from PubMed on 06 Jul 2025.
Read full publication at:
Please sign in
to see all details.
Advertisement
Stats
- Recommendations n/a n/a positive of 0 vote(s)
- Views 51
- Comments 0