Rupture infected pseudoaneurysm on brachiocephalic AV-fistula: emergency and definitive management

Background: Vascular access bleeding is a rare event that can be fatal in hemodialysis patients. It requires emergency and surgical management to reduce the risk of ischemic events patient’s forearm mortality risk. Objective: To describe clinical presentation, intervention, outcome rupture-infected anastomotic pseudo aneurysm brachiocephalic arteriovenous fistula underwent definitive procedure. Case Description: A 55-year-old man presented with on AV-fistula surgery site, accompanied pain swelling his occurred 3 hours before admission hospital. The Patient had history weeks earlier. On physical examination, was found site wound looked wet swollen, lots necrotic tissue pus lost stitches. In Emergency Departments, patient administered intravenous normal saline fluids, inhibitors pressure bandages ongoing bleeding. Then planned for immediate vascular reconstruction surgery. brachial artery repaired using great saphenous vein patch plasty. Results: postoperative 30-days follow-up went well, there no sign complication, such as pain, infection, paresthesia, at or ischemia distal forearm. Conclusion: Optimal treatment patient's life top priority. good assessment condition AVF choice subsequent therapy greatly affect prognosis.