*4.2.3 Aneurysm*

Repeated cannulation at repetitive sites or turbulent blood flow due to stenosis is the major causes of formation of aneurysm. It is seen in about 5 to 7% cases. Physiological and esthetic complications due to aneurysm lead to surgery in many cases and may cause failure subsequently. Increased infection risk and prolonged bleeding after dialysis along with complex surgery are common associated complications of aneurysm. On scanning, outpouching with or without color flow is seen arising from vessels (**Figure 11**). Most common site is the needle insertion site. The aneurysm may show to and frocolor flow and peripheral thrombosis. In case of thrombosis, patent lumen commonly shows color flow. The entire length of vessel should be traced as finding more than one aneurysms is not uncommon. Totally thrombosed aneurysm sometime look like old hematoma and in such cases proper history and careful evaluation in terms of connection with the vessel wall should be done. Internal color flow can clear the doubts in such cases. Treatment of aneurysm consists of its prevention in the form of careful cannulation techniques and surgical correction techniques [2].

#### **Figure 11.**

*(a) Gray scale image showing aneurysm arising from brachial artery in mid arm with peripheral thrombosis and (b) CDI study showing color flow in patent lumen.*
