Aneurysms and pseudoaneurysms in dialysis access

Abstract

Aneurysms are a common and often difficult complication seen with arteriovenous vascular access for haemodialysis. The purpose of this narrative review is to define and describe the scale of the problem and suggested therapeutic strategies. A narrative reviewof the published literature illustrated by individual cases is presented with the aim of summarising the relevant literature. The definitions of aneurysmare inconsistent throughout the literature and therefore systematic reviewis impossible. They vary from qualitative descriptions to quantitative definitions using absolute size, relative size and also size plus characteristics. The incidence and aetiology are also ill defined but separation into true aneurysms and false, or pseudoaneurysms may be helpful in planning treatment, which may be conservative, surgical or radiological. The lack of useful definitions and classification along with the multitude of management strategies proposed make firm evidence based conclusions difficult to draw. Further robustwell designed studies are required to define best practice for this common problem.