Aneurysmorrhaphy using exoprothesis. New surgical treatment for haemodialysis arterio-venous fistula aneurysm.

Introduction: Haemodialysis arterio-venous fistula aneurysm (AAVF) prevalence varies between 7-43%. When they are symptomatic, they should be referred for treatment. It is unclear which is the optimal surgical treatment and if fistula flow reduction is beneficial for heart remodeling in patients with high-flow AAVF. Aims: (1) introduction of a new surgical technique - aneurysmorrhaphy using exoprothesis (AuE) and evaluation of its patency and complication rates. (2) analysis of flow reduction impact on heart remodeling in high-flow AAVF. (3) systematic review and meta- analysis of various surgical techniques to identify the best treatment option of haemodialysis arterio-venous fistula aneurysm. Methods: (1) retrospective analysis with prospectively collected surgical and postoperative data, patency evaluation using Kaplan - Meier curve, early and late complication rates analysis. (2) retrospective analysis prospectively collected echocardiographic parameters before and after surgery. (3) systematic review and meta- analysis following the PRISMA guidelines - registered in the international prospective register of prospective reviews PROSPERO (registration number: CRD42016029692). Results: (1) primary assisted patency rate at 12 months was 80 %, infection rate was 4.5 % and AAVF recurrence rate was 0..