@article{Almerey_Oliver_Jorgensen_Rinker_Farres_Hakaim_Forte_2020, title={Upper extremity reconstruction following open surgical repair of giant arteriovenous fistula aneurysm: clinical case and systematic review of the literature}, volume={91}, url={https://mattioli1885journals.com/index.php/actabiomedica/article/view/8472}, DOI={10.23750/abm.v91i4.8472}, abstractNote={<p><strong>Background:</strong> Nearly 30% of arteriovenous fistulas (AVFs) located in the upper extremity for hemodialysis access result in short- and long-term adverse effects, such as rupture, necessitating emergent surgical management and extensive soft-tissue reconstruction. With this systematic review, we aimed to compile all reported open surgical techniques used for complicated AVF repair in the upper extremity, the respective soft-tissue reconstructive outcomes, and vascular patency rates at final follow-up.</p> <p><strong>Methods: </strong>Using Ovid Medline/PubMed databases, we conducted a review of the English-language literature on AVF aneurysm surgical management in the upper extremity, filtered for relevance to open surgical technique and outcomes in vascular patency after aneurysmal repair at long-term follow-up (≥6 months postoperatively). We include a detailed case of surgical removal of a giant AVF aneurysm and subsequent flap elevation and reconstruction of the upper extremity.</p> <p><strong>Results: </strong>Of 150 articles found in the initial search, 19 (from 2010-2017) met inclusion criteria. From the reviewed studies, 675 patients underwent open surgical repair of AVF aneurysm in the upper extremity. Surgical approaches included partial-to-full aneurysm excision, interposition graft, tubularized extracellular matrix, sutured and stapled aneurysmorrhaphy, and stent graft. Rates of vascular patency at repair site ranged from 47% to 100%, with a pooled average of 78% at 6 months or longer postoperatively.</p> <p><strong>Conclusions: </strong>For plastic and hand surgeons, aneurysmal ligation and excision is feasible even in severe cases and is associated with overall good vascular and soft-tissue reconstructive outcomes in the upper extremity.</p> <p><strong>Level of Evidence: </strong>III</p>}, number={4}, journal={Acta Biomedica Atenei Parmensis}, author={Almerey, Tariq A and Oliver, Jeremie D and Jorgensen, Matthew S and Rinker, Brian D and Farres, Houssam A and Hakaim, Albert G and Forte, Antonio Jorge}, year={2020}, month={Nov.}, pages={e2020093} }