Venous pseudoaneurysm of left brachiocephalic fistula treated by excision and aneurysmorrhaphy: A case report

INTRODUCTION AND IMPORTANCE: Brachiocephalic fistula, an arteriovenous fistula approach for hemodialysis in Chronic Kidney Disease patients, can cause various complications. Pseudoaneurysm in the venous end of the arteriovenous fistula is one of those unusual presentations, and can lead to the failure of vascular access. CASE PRESENTATION: We present a case of a 38-year-old female with pseudoaneurysm in the venous end of the left brachiocephalic fistula presenting as painless swelling for one month. Surgical management was done with excision followed by aneurysmorrhaphy. CLINICAL DISCUSSION: The repair is associated with risks of arteriovenous fistula failure, thromboembolism, bleeding manifestation and graft rupture. Surgical correction should be done as early as possible with consideration of size, location, and available resources. CONCLUSION: Venous pseudoaneurysm in a brachiocephalic fistula is an unusual complication which requires prompt surgical correction.