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KMID : 1038220210480030287
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Archives of Plastic Surgery
2021 Volume.48 No. 3 p.287 ~ p.292
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A dual-plane approach for surgical treatment of pseudoaneurysm with arteriovenous fistula in hemodialysis patients
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Kim Ji-Min
Tak Min-Sung
Kang Jin-Seok
Moon Chul
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Abstract
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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.
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KEYWORD
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Pseudoaneurysm, Hemodialysis, Surgical flap
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