Abstract: Objective  To investigate the mid- and long-term effects of different surgical methods to resect arteriovenous fistula aneurysm (AVFa) on fistula function. Methods We retrospectively analyzed the clinical data of 36 patients undergoing surgical treatment of AVFa at our center between Feb. 2016 and Feb. 2020. Eighteen patients underwent aneurysmorrhaphy to reshape the new AVF, 13 ineligible patients underwent aneurysm resection with outflow reconstruction to construct a new dialysis pathway, and 5 patients had only aneurysm resection and failed to retain fistula function. All patients were followed up for 36 months.   Results The 18 patients undergoing aneurysmorrhaphy dialyzed with the primary AVF immediately after surgery, with normal AVF function and no recurrence of aneurysm in follow-up study. Of the 13 patients undergoing reconstruction of the outflow tract, 5 had anastomotic stricture in the 36 months period of follow-up. The fistula became patent after PTA treatment and could be used normally. The remaining 5 patients underwent AVFa resection.  Conclusion  Aneurysmorrhaphy is an effective treatment for AVFa in hemodialysis patients, can preserve adequate vascular resources in forearm for hemodialysis, and has satisfactory mid- and long-term patency rates.

Key words: Arteriovenous fistula aneurysm, Hemodialysis, Aneurysmorrhaphy