# resection aneurysm AV fistula



## lindacoder (Aug 9, 2013)

After appropriate local anesthetic field block, an elliptical incision containing the scar tissue and previous puncture sites in the skin was excised for a distance of approximately 12 cm. This exposed the aneurysm. The aneurysm was then freed from all its attachments proximally and distally for a distance of about 10 cm. We were able to get proximal and distal control with Fogarty clamps. After this was accomplished, the aneurysm was opened and the distal limb was flushed with heparin.  The excess venous wall fo the aneurysm was excised. The vein was then closed primarily for about  a 10 cm distance with running 5-0 Prolene. Clamps were removed. There was excellent flow and thrill throughout the fistula. Th skin was closed over the repaired aneurysm with interrupted 4-0 nylon. 

Looking at either 36832, 36833 or 35011 - any ideas???

Thankis


----------

