Late, Acute Presentation of a Large Brachial Artery Aneurysm Following Ligation of a Brescia-Cimino Arteriovenous Fistula

Abstract 

The development of pan-arterial dilatation proximal to longstanding traumatic arteriovenous fistulae (AVF) was first described by John Hunter over two centuries ago.¹ This is thought to be due to abnormal and hyperdynamic arterial flow patterns proximal to the AVF, which renders the proximal arteries particularly susceptible to atherosclerotic change and aneurysmal dilatation. Aneurysmal arterial dilatation has been described infrequently as a late complication of traumatic AVF formation, however, we describe a case in which acute on chronic late brachial artery aneurysmal dilatation occurred following previous Brescia-Cimino AVF formation, which had been ligated several years earlier after renal transplantation.

Keywords: Brescia-Cimino fistula, Arteriovenous fistula, Brachial artery aneurysm