Endovascular Creation of an Arteriovenous Fistula (endoAVF) for Hemodialysis Access: First Results

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

Abstract

Introduction: Surgical creation of a radiocephalic fistula is the gold standard of vascular access for hemodialysis. Recently, an endovascular approach for upper arm fistula creation (endoAVF) has been developed, which may be an alternative to open surgery. We describe a case series of eight cases showing feasibility, early complications and outcome of this novel treatment option. Materials and Methods: Between July 2015 and February 2016, we created an endoAVF in eight patients. Indications for endoAVF were confirmed by a multidisciplinary vascular board upon the exclusion for Cimino fistula candidates. Patients were suitable for the procedure after a pre-therapeutic ultrasound showed adequate brachial and ulnar vessels and no ipsilateral central venous stenosis. Patient characteristics, technical success, total patient radiation dose, complication rates, time to maturation of endoAVF and clinical effectiveness at six months were assessed retrospectively. Results: Creation of endoAVF using the everlinQ endoAVF system (TVA Medical Inc., Austin, TX, USA) was successful in all eight cases. There were one minor intraprocedural complication and no postoperative complications. Median time to endoAVF maturation was 63 days (range 26–137 days). One patient was lost to follow-up after the first monitoring visit. In the remaining seven patients, hemodialysis was started without problems. Patency after 6 months was 100%. Discussion: The endoAVF demonstrated to be feasible and safe for the creation of arteriovenous fistula suitable for hemodialysis access. Further studies with more patients and longer follow-up periods are needed to assess long-term outcomes and comparability to surgical dialysis access creation.

Details

Original languageEnglish
Pages (from-to)1545-1551
Number of pages7
JournalCardiovascular and interventional radiology
Volume40
Issue number10
Publication statusPublished - 1 Oct 2017
Peer-reviewedYes

External IDs

PubMed 28785804
ORCID /0000-0001-5061-9643/work/163294715

Keywords

Keywords

  • Arteriovenous fistula, Dialysis, End-stage renal disease, Endovascular AV fistula, Hemodialysis, Interventional radiology, Vascular access