透析患者におけるブラッドアクセス穿刺部仮性動・静脈瘤の2例

Abstract

This is a report of blood access puncture point pseudoaneurysms which occurred in two hemodialysis patients. Case 1: A 58-year-old male had been undergoing hemodialysis treatment since June, 1975. In January, 1981 a subcutaneous mass had developed at the blood access puncture point above the previously superficialized left femoral artery. An operation was performed in February, 1981 and the mass was dissected. The same artery has been used since the operation for blood access without any problems. The dimensions of the egg-shaped dissected mass were 3.5 X 4 X 2.5 cm. A histological diagnosis of the wall of the mass showed that it was a pseudoaneurysm. Case 2: A 48-year-old female had been undergoing hemodialysis treatment since September, 1983. The left basilic vein, connected to the brachial artery, has been used for blood access. In April, 1984, a subcutaneous mass had developed at the blood access puncture point and an operation was performed within a few days. Operative findings revealed that the mass was a capsulized infected hematoma with a smooth but extremely thin and easily ruptured surface, and the section of the basilic vein surrounded by the mass showed evidence of necrotic change due to compression. The brachial artery was resutured at the region where it was previously connected to the basilic vein without disturbance of arterial blood flow. In July, 1985, an operation was performed in which a new blood access was constructed in the left thigh by superficializing the femoral artery and connecting its side to the end of the saphenous vein.(ABSTRACT TRUNCATED AT 250 WORDS)