(a) This brachial artery has fed a forearm fistula for 17 years and developed major ­aneurysmal degeneration with stretching and thinning of the overlying skin (arrows). Hyper flow and subsequent enlargement of the arterialized vein were successfully controlled by arterial ligations at the anastomosis. (b) Arteriography via the femoral artery shows a huge markedly tortuous brachial artery