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.