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* Traditional treatments like compression or thrombin injection may risk blocking the fistula, while covered stents can lead to infections and other complications.
* The case study discusses using endovascular balloon occlusion combined with ultrasound-guided thrombin injection to safely treat a dialysis access pseudoaneurysm, showing it as an effective and minimally invasive alternative.
Article Abstract
Arteriovenous fistulas are known to be one of the most enduring and safe hemodialysis access modalities. However, access preservation can be challenging in the setting of degeneration, including the development of complex pseudoaneurysms. Prolonged compression or thrombin injection can risk thrombosis of the fistula, and covered stent use can predispose the access to infection and other stent complications. We present a case in which endovascular balloon occlusion was used to facilitate the use of ultrasound-guided thrombin injection to resolve a dialysis access pseudoaneurysm by transiently reducing flow and preventing thromboembolism. This method is a safe, effective, and minimally invasive technique that should be considered for salvage of autogenous access compromised by pseudoaneurysm development.
