The incidence of aneurysm formation in autogenous arteriovenous fistulas (AVF) is reported to be as high as 30% and 2%-10% of these present with a complication. The sequelae of aneurysm formation in AVF include skin breakdown, bleeding, rupture, thrombosis, poor flow resulting in inadequate dialysis  and infection. K-DOQI guidelines recommend intervention to be performed on aneurysmal AVF and that aneurysmal AVF segments should not be cannulated. There is a variety of surgical techniques available and the most frequently mentioned in the literature are: resection and interposition vein or PTFE graft, partial resection and “refashioning” or “reshaping” the aneurysm. Other techniques include: segmental bypass around the lesions, new AVF, bypass to more proximal vein and ligation of the access. In the present time no prospective randomized study exists of the techniques described above and therefore no conclusion can be made to which of these techniques is considered the method of choice for aneurysmal AVF management. In 2008 Balaz et al. as first in the world described a new vein salvage technique consisting of venous aneurysmorrhaphy followed by placement of an open-pore external support prosthesis to reinforce the wall of the repaired vein (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.).