A dual-plane approach for surgical treatment of pseudoaneurysm with arteriovenous fistula in hemodialysis patients
- Author:
Ji Min KIM
1
;
Min Sung TAK
;
Jin Seok KANG
;
Chul MOON
Author Information
- Publication Type:Original Article
- From:Archives of Plastic Surgery 2021;48(3):287-292
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:We report the efficacy of a dual-plane approach using a Dufourmentel skin flap with a purse-string suture of the de-epithelized dermis to manage pseudoaneurysm at the vascular access site for hemodialysis.
Methods:A retrospective analysis was conducted of 61 patients from 2013 to 2018 with pseudoaneurysms at the arteriovenous fistula or graft who were treated with rhomboid excision, vessel repair with a purse-string suture, and a full-thickness Dufourmentel skin flap. The success rate was defined as the probability of complete wound closure and intact vascular access patency without infection or other complications.
Results:The success rate was 93.4% at 6 months postoperatively. Complications included newly occurring pseudoaneurysms (n=2), wound dehiscence (n=1) and bleeding (n=1). There were no complications such as stenosis or thrombosis from the procedure.
Conclusions:A dual-plane approach using a Dufourmentel skin flap with a purse-string suture for vessel repair was shown to be a favorable option for managing stable, small (diameter <2 cm) pseudoaneurysms without infection, rapid expansion, or patency issues of the vascular access.
