Endovascular treatment of arteriovenous graft pseudoaneurysms, indications, complications, and outcomes: a systematic review

Hemodial Int. 2014 Oct;18(4):785-92. doi: 10.1111/hdi.12152. Epub 2014 Mar 16.


There are limited data regarding endovascular treatment of arteriovenous graft (AVG) pseudoaneurysms using stent grafts. We performed a comprehensive literature review on the use of stent grafts in the treatment of AVG pseudoaneurysms. We included 10 studies (121 patients). The mean AVG age was 3.1 years (95% confidence interval [CI]: 2.2-4) and pseudoaneurysm mean diameter was 34 mm (95% CI: 23-46). The majority (71%) of the pseudoaneurysms were located on the arterial limb of the AVG and 77% presented with venous anastomosis stenosis requiring angioplasty. The mean number of stents used to treat one lesion was 1.4 (95% CI: 1.3-1.5). The technical success rate of pseudoaneurysm isolation was 100% in all studies and 100% of patients received hemodialysis using the AVG after pseudoaneurysm treatment without the need for catheter placement. The primary patency rates for 1, 3, and 6 months were 81%, 73%, and 24%. Secondary patency was 80%, 77%, and 74% at 1, 3, and 6 months. Arteriovenous graft thrombosis occurred in 12% of patients. Arteriovenous graft infection developed in 35% of cases. Arteriovenous graft pseudoaneurysm treatment using stent grafts is effective in managing even large pseudoaneurysms and has acceptable primary and secondary patency rates. Graft infection was a relatively frequent complication.

Keywords: Arteriovenous graft; hemodialysis; pseudoaneurysm; stent graft.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aneurysm, False / complications
  • Aneurysm, False / therapy*
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Renal Dialysis / adverse effects*
  • Renal Dialysis / methods
  • Treatment Outcome