Transluminal Stent-Graft Repair for Pseudoaneurysm of PTFE Hemodialysis Grafts

Abstract

Purpose: To report the use of endovascular techniques to treat two cases of nonanastomotic pseudoaneurysm of a bridge graft fistula (BGF). Methods and Results: Two men with fully functional polytetrafluoroethylene (PTFE) BGFs both presented with an enlarging mass adjacent to their arteriovenous shunt. The false aneurysm in both instances was located by ultrasound and confirmed by shunt angiography at the time of surgery. Both fistulas were repaired by transluminally introducing a stented graft composed of a balloon-expandable Palmaz stent covered with a PTFE graft. Completion arteriography confirmed normal flow through the graft with no communication between the lumen and the aneurysmal cavity. Both patients recovered without complications and were discharged on the day of the procedure. Follow-up data reveal that both fistulas remain fully functional up to 5 and 6 months, respectively. Conclusions: Endovascular repair using stent-grafts can be a safe and effective method of excluding pseudoaneurysms associated with PTFE BGFs.