Arteriovenous fistula takedown in hemodialysis patients: our experience of 26 cases

Introduction
Creation of arteriovenous fistulas (AVF) for providing vascular access in patients dependent on hemodialysis is a very frequent type of surgery. One of the common complications of such a fistula is the formation of an aneurysm or a pseudoaneurysm and the risk of impending rupture. These are a few of the reasons why such surgically created AVF have to be taken down surgically. Some of these may be taken down for cosmetic reasons electively while some present in an emergency due to rupture of the aneurysm itself.

Aim
This is a retrospective study of 26 patients who underwent AVF takedown at our center over a period of 4 years.

Material and methods
We intended to study the patient profile, the surgery that they underwent and the post-operative course of these patients.

Results
We found that aneurysm formation was the most common reason for a takedown, although we did see a good percentage of patients who presented to us with a ruptured AVF aneurysm. Our procedure was a ligation of the aneurysm with resection of the aneurysmal segment and maintaining arterial continuity. No attempt to preserve the fistula was made in any of these cases.

Conclusions
This article gives a brief overview of our experience in AVF takedown.