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The salvage technique for the treatment of the vascular access arteriovenous fistula aneurysm using aneurysmorrhaphy with external prosthesis was first developed and published in 2008 by vascular surgeons from the Institute of Clinical and Experimental Medicine (IKEM), Prague, Czech Republic. This new technique consists of venous aneurysmorrhaphy followed by placement of an open-pore external support prosthesis to reinforce the wall of the repaired vein.  Furthermore, we have designed and developed a new surgical instrument the BalRok clamp to simplify this unique technique. 

The aneurysmorrhaphy of the hemodialysis arteriovenous fistula aneurysm with the BalRok clamp allows the vascular surgeon precise and considerate aneurysm resection within a few minutes.


Repair of Aneurysmal Arteriovenous Fistulae: A Systematic Review and Meta-analysis. Eur J Vasc Endovasc Surg. Baláž P, Rokošný S, Bafrnec J, Whitley A, O'Neill S. 2020;59(4):614–623. doi:10.1016/j.ejvs.2019.07.033

Contemporary management of arteriovenous hemodialysis fistula aneurysms. Rokosny S, O’Neill S, Balaz P. Cor et Vasa 2018, 60(1):e49-e55, doi:10.1016/j.crvasa.2017.10.005

Cardiac remodeling after reduction of high-flow arteriovenous fistulas in end-stage renal disease. Wohlfahrt P, Rokosny S, Melenovsky V, Borlaug BA, Pecenkova V, Balaz P. Hypertens Res. 2016;39(9):654–659. doi:10.1038/hr.2016.50

True aneurysm in autologous hemodialysis fistulae: definitions, classification and indications for treatment. Balaz P, Björck M. J Vasc Access. 2015;16(6):446–453. doi:10.5301/jva.5000391

Reinforced Aneurysmorrhaphy for True Aneurysmal Haemodialysis Vascular Access.
Rokošný S, Baláž P, Wohlfahrt P, Palouš D, Janoušek L. Eur J Vasc Endovasc Surg. 2014, doi: 10.1016/j.ejvs.2014.01.010

Aneurysmorrhaphy is an easy technique for arteriovenous fistula salvage. Balaz P, Rokosny S, Klein D, Adamec M. J Vasc Access. 2008 Apr-Jun;9(2):81-4.