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CC BY-NC 4.0 · Arch Plast Surg 2021; 48(03): 287-292
DOI: 10.5999/aps.2020.02068
Hand/Peripheral Nerve
Original Article

A dual-plane approach for surgical treatment of pseudoaneurysm with arteriovenous fistula in hemodialysis patients

Ji Min Kim 
Department of Plastic and Reconstructive Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
,
Min Sung Tak 
Department of Plastic and Reconstructive Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
,
Jin Seok Kang 
Department of Plastic and Reconstructive Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
,
Chul Moon 
Department of General Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
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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.

Keywords

Pseudoaneurysm - Hemodialysis - Surgical flap


Publication History

Received: 27 October 2020

Accepted: 24 February 2021

Article published online:
21 March 2022

© 2021. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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