Resection and Primary Repair of an Arteriovenous Fistula Aneurysm in a 29-Year-Old Female Patient With Systemic Lupus Erythematosus: A Case Report

Arteriovenous fistulas (AVFs) are a common vascular access method for patients with end-stage renal disease requiring hemodialysis, but they can develop complications such as aneurysms, which may compromise access function and patient comfort. We report the case of a 29-year-old female patient with systemic lupus erythematosus (SLE) and KDIGO (Kidney Disease: Improving Global Outcomes) V chronic kidney disease who developed a painful aneurysm in the venous segment of a brachiocephalic AVF. Clinical evaluation revealed a dilated, erythematous, and tender venous segment without thrill. The patient underwent surgical resection of the aneurysmal segment and primary end-to-end repair, using a Nelaton probe for internal support and reinforcement with fibrin sealant. Postoperative recovery was favorable, with complete symptom resolution and adequate flow confirmed on follow-up ultrasound two months later. This case illustrates the effectiveness of surgical management with primary repair in selected patients and highlights the need for individualized treatment strategies, particularly in those with risk factors such as immunosuppressive therapy. Further research comparing surgical and endovascular approaches is warranted to optimize outcomes in AVF-related aneurysms.