Operation performed:
1. Aneurysmectomy of the right upper extremity AV fistula aneurysm.
2. Ulcer resection of this ulceration of the skin in the right upper extremity.
3. Aneurysmorrhaphy and aneurysmectomy with ulcer resection.
Indications for procedure: t
This is a patient, who has right upper extremity AV fistula and he then has had aneurysmal disease dilatation in _____ segments as well as an ulceration of the skin that is at risk of rupturing.
Procedure:
The patient was appropriately consented and brought to the operating room, prepped and draped in sterile fashion. Right upper extremity was prepped in sterile field. Infusion of lidocaine anesthetic was infused around the larger of the 2 masses and an encompassing separation of the ulceration from the AV fistula took place. Sharp elliptical incision was made around the larger of the 2 masses _____ was made, carried around the proximal and distal portions of the AV fistula and the ulceration was resected, sent off to pathology. The same was done for the aneurysm. Aneurysm was encircled proximally and distally. There was control that was made and a subsequent aneurysmectomy took place with aneurysmorrhaphy using running 6-0 prolene suture as well as a endo-gia stapler _____ . After the case, there was a good thrill through the fistula and good hemostasis and the fistula was in good shape and much more _____ caliber and size postprocedure. the patient tolerated the procedure well. A running 3-0 nylon was used to close the suture.