Occurs from trauma to vascular accesses (i.e. arteriovenous fistula (AVF) or arteriovenous graft (AVG)) when the access is repeatedly cannulated in the same area. The dilatations that occur can expand further when there is a downstream stenosis that causes increased intra-access pressure. In an AVF, pseudoaneurysms are more common than a true aneurysm and are due to lack of cannulation site rotation. When these occur in an AVF, the site is observed for possible impending rupture and avoidance of cannulation at the aneurysm site. Unlike the expansion of the AVF vessel wall, a pseudoaneurysm in an AVG is formed by a layer of external soft tissue. Surgical revision is considered in an AVG when the pseudoaneurysm limits cannulation site availability or the patient has symptoms such as persistent pain or throbbing.
Yevzlin, A., Agarwal, A. K., Salman, L., & Asif, A. (2015). Arteriovenous vascular access monitoring and complications . In J.T. Daugirdas, P.G. Blake, & T.S. Ing. (Eds, 5th ed.). Handbook of dialysis. Philadelphia: Wolters Kluwer.