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Case Reports
. 2015 Dec 17;10(1):519-522.
doi: 10.1515/med-2015-0088. eCollection 2015.

Venous aneurysm complicating arteriovenous fistula access and matrix metalloproteinases

Raffaele Serra  1 , Lucia Butrico  2 , Raffaele Grande  2 , Girolamo Domenico Placida  3 , Paolo Rubino  3 , Ugo Francesco Settimio  2 , Gennaro Quarto  4 , Maurizio Amato  4 , Ermenegildo Furino  4 , Rita Compagna  5 , Bruno Amato  5 , Luca Gallelli  6 , Stefano de Franciscis  7
Affiliations
Case Reports

Venous aneurysm complicating arteriovenous fistula access and matrix metalloproteinases

Raffaele Serra et al. Open Med (Wars). .

Abstract

Introduction: An arteriovenous fistula (AVF) for placed for hemodialysis may be burdened by one particular complication-the formation of a venous aneurysm. It has been shown that matrix metalloproteinases (MMPs) and neutrophil gelatinase-associated lipocalin (NGAL) could represent markers of disease in both venous and arterial vessels.

Materials and methods: This case study reports a rare case of enormous venous aneurysm-correlated MMP and NGAL levels in a woman with an AVF.

Results: Significantly higher levels of plasma MMP-1, MMP-8, MMP-9, and NGAL were detected in this patient during aneurysmal evaluation before the surgery; these levels significantly decreased 1, 3 and 6 months after surgery.

Conclusion: MMP and NGAL levels could represent a marker of aneurysmal disease, and their plasma evaluation could help physicians to stratify the risk of complications in patients with an AVF.

Keywords: MMP; NGAL; arteriovenous fistula; hemodialysis; matrix metalloproteinases; neutrophil gelatinase-associated lipocalin.

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Figures

Figure 1
Figure 1
A very large mass in the left arm.
Figure 2
Figure 2
Incision along the medial bicipital groove on the left arm.
Figure 3
Figure 3
Specimen of the dissected aneurysm after aneurysmectomy.
Figure 4
Figure 4
MMP-1 (A), MMP-8 (B), MMP-9 (C), and NGAL (D) plasma levels in an aneurysmatic patient measured by ELISA. In aneurysmatic patient, levels of MMPs were measured before surgery (T0), and 1 (T1), 3 (T2), and 6 (T3) months later. **p < 0.01 respect to T0.
See this image and copyright information in PMC

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