Purpose: Devices to permit percutaneous endovascular arteriovenous fistula formation have recently been introduced into clinical practice with promising initial evidence. As guidelines support a distal fistula first policy, the question of whether an endovascular arteriovenous fistula should be performed as an initial option is introduced. The aims of this study were to compare a matched cohort of endovascular arteriovenous fistula with surgical radiocephalic arteriovenous fistulas. Materials and methods: Using data from a prospectively collected database over a 3-year period, a matched comparative analysis was performed. Results: WavelinQ arteriovenous fistulas (group W, n = 30) were compared with radiocephalic arteriovenous fistulas (group RC; n = 40). Procedural success was high with 96.7% for group W and 92.6% for group RC. Primary patency at 6 and 12 months was greater in group W (65.5% 6mo and 56.5% 12mo) compared to group RC (53.4% 6mo and 44% 12mo) ( p = 0.69 and 0.63). Mean primary patency was significantly lower for RC (235 ± 210 days) vs W (362 ± 240 days) ( p < 0.05). Secondary patency for group W was 75.8% and 69.5% at 6 and 12 months, respectively. Secondary patency for RC was lower at 66.7% and 57.6% at 6 and 12 months, respectively. Conclusion: Outcomes of WavelinQ arteriovenous fistulas in this series are similar to published results. When compared to a contemporaneously created group of surgical fistulas, WavelinQ demonstrated superior outcomes. These data would support that WavelinQ endovascular arteriovenous fistulas may be considered as a first option in the access pathway particularly if vessels at the wrist are absent or less than ideal.

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SLF was strongly supportive of successful fistula maturation. A "thrill" was characteristic of spiral rather than turbulence. The mechanism of this apparent beneficial effect of this pattern of flow requires further investigation.