Arteriovenous fistula aneurysm--plicate, not ligate.

INTRODUCTION: Arteriovenous fistula (AVF) created for haemodialysis can be complicated by aneurysm formation.

CLINICAL PICTURE: Ligation of the fistula is often required to prevent aneurysmal rupture and the life-threatening haemorrhage that ensues. Other methods of treatment involve using foreign bodies like mesh and grafts.

TREATMENT: We describe a new method in the treatment of this condition--plication. It involves plicating the excess free wall of the aneurysm with sutures and does not require resection or anastomosis.

OUTCOME: Early results show that this method shrinks the aneurysm size and reduces the risk of haemorrhage.

CONCLUSION: The AVF can continue to be used and the patient is spared the agony of having to go through the entire cycle of creating a new vascular access site.