Angioaccess procedures for hemodialysis over a 12-year period were retrospectively reviewed to ascertain the frequency of aneurysm complications. A total of 571 angioaccess procedures were performed including 88 polytetrafluoroethylene grafts. 1.24% autogenous fistulae and 5.7% ePTFE grafts had uncomplicated aneurysm. Complicated (thrombosis, bleeding, infection) aneurysm occurred in 5.2% autogenous fistulae and in 5.7% PTFE grafts. The authors recommend a surgical repair of all angioaccess-associated aneurysms in the time of uncomplicated occurrence. If the aneurysm is complicated, the risk of the function lose of the av shunt by surgical therapy increase.