questions about Aneurysms

[sullidog]

I noticed this hump forming on the arterial side of my graft where it sticks up just above the elbow. It also thumps instead of having a smooth thrill like the rest of my graft. I had my dialysis nurse look at it and she says it is a small suto Aneurysm but isn't a concern right now. I have my monthly followup with my v surgeon next week so we'll see what he says.
I have a few questions though.
Can an Aneurysm develop in a graft even though it is synthetic?
How is a Aneurysm of the dialysis access removed?
Will I lose my graft?
I have advised them not to stick in that spot anymore, which they didn't do a whole lot of anyways so I have no idea on how I even got it in the first place.

[Restorer]

Is it a hard lump, or is it soft like it's filled with blood (like a vein)? I have a fistula, not a graft, but when I straighten my arm out I have a solid lump right under the right side of the fistula scar, where the artery and vein are connected and scar tissue formed. It has a thumping kind of thrill too, like a normal thrill interrupted by my pulse. I assume it's normal because it's been looked at many times, and my fistula's working perfectly.

Could it just be a (new?) build up of scar tissue around the arterial side of the graft?

[noahvale]

^

[dialysisadvocate]

My father did not have a graft, but a fistula (natural) but he developed MANY pseudoaneurysms due to staff NOT sticking correctly e.g. they inserted needles in the same place and did NOT rotate sites -- there is one procedure called 'step ladder' whereby the needles go up and then down the arm, rotating the sites in order to prevent the pseudoaneurysms -- You can always call your doctor, or the access center to ask questions about this, before  your appointment, to ease you mind.. Staff should not be inserting needles in the same place unless you have a buttonhole...
I remember bringing information back to the unit, from the interventional nephrologist, about cannulating and the staff and unit doctor became defensive etc to the point that once again I was seen at interfering with my father's care..

it is interesting how physicians and staff don't recognize just wanting what is best for your loved one, or yourself (being an advocate for yourself, or a loved one) but see you as a problem, etc.

There is alot of information on pseudoaneurysms and grafts on line is you google it ---but again, call your doctor to alleviate any worry unecessary if it will help

opinions of Roberta Mikles - Dialysis Patient Safety Advocate - www.qualitysafepatientcare.com

[sullidog]

Matt, the description you gave sounds a lot like mine. It seems to be soft, and I can tell you the area in question has been cut open a few times and punctured for thrombectomies/ interventions.

[RichardMEL]

JUst a comment - I have 2 pretty big aneurysms on my arm from all the needling... unfortunately my unit discovered buttonhole needling after it was too late. My fistula is still buzzing away.. the only thing that's "bad" about them is that they are large and well obviously people see them and think what kind of freak is this? (one guy once thought they were boils and stayed well away from me.. lol). so no I do't think they will affect the graft having them..... I also don't think you can easily get rid of them - alas

[mogee]

The way to prevent a pseudoaneuryism in a fistula is to use the buttonhole cannulation technique.  For a graft one should use the rope ladder technique.  I have successfully prevented any disfiguration in my arms this way.