Poll Results
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AV fistula pseudoaneurysm
Explanation
After thrombosis and infection, false or “pseudo” aneurysms are the third most frequent complication of hemoaccess. They occur in 2-10% of patients and are thought to be caused by repeated needle punctures in the same location.1
While true aneurysms include layers of the arterial wall, pseudoaneurysms are caused by defects in vessel walls that result in hematomas contained by tissues outside the arterial wall – hence the term “pseudo”. They present with a painful swollen upper extremity with tense overlying skin.
Diagnosis can be made by bedside ultrasound demonstrating the classic “yin and yang sign” of swirling blood within the aneurysm.2 Of note, the yin-yang sign can be seen for true aneurysms and pseudoaneurysms. Definitive correction of a pseudoaneurysm can be performed by ultrasound compression, endovascular repair, or surgical repair.
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Author information
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