Clinico-Etiological Profile and Management of Arteriovenous Fistula Blowouts in HemodialysisPatients: A Retrospective Single-Center Observational Study

Background: Arteriovenous fistula (AVF) blowout is a rare but life-threatening complication of hemodialysis access. This study evaluated the clinico-etiological profile, management, and outcomes of AVF blowouts. Material and Methods: A retrospective observational study was conducted at Kurnool Medical College between January 2020 and December 2025. Patients presenting with AVF blowouts requiring surgical intervention were included. Demographic data, etiology, management, and outcomes were analyzed using descriptive statistics. Results: Twenty-five patients were included. The mean age was 48.8 years, and 68% were male. Pseudoaneurysm was the most common etiology (56%), followed by infection (24%). Active bleeding occurred in 76% of patients. AVF ligation was performed in 22 patients (88%), while salvage by excision and primary repair was attempted in three patients, with successful preservation in two (66.7%). No mortality or rebleeding was observed during 1–3 years of follow-up. Conclusion: Pseudoaneurysm and infection are the leading causes of AVF blowouts. Emergency surgery provides effective hemorrhage control, while AVF salvage is feasible in selected patients.

Keywords: Arteriovenous fistula; Hemodialysis; Pseudoaneurysm; Blowout; Vascular access; Salvage repair.