Percutaneous Creation of an Arteriovenous Fistula for Hemodialysis Access

Rajan, Dheeraj K.; Ebner, Adrián; Desai, Sudhen B.; Rios, Jesus M.; Cohn, William E.

doi:10.1016/j.jvir.2014.12.018

Cited by 90 publications

(67 citation statements)

References 30 publications

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“…The addition of buttonhole cannulation and selective ultrasound guided initial puncture for the patients in this study has resulted in very encouraging results. Rajan et al, using a different system for pAVF creation, reported 33 patients with a pAVF maturation mean time of 58 days (range 37–168 days) with one serious procedure‐related adverse event and five minor procedure‐related adverse events . Several authors have noted a low risk of proximal radial artery access‐related steal syndrome and reported more moderate AVF flow volume compared with AVFs based on the brachial artery …”

Section: Discussionmentioning

confidence: 99%

“…Rajan et al, using a different system for pAVF creation, reported 33 patients with a pAVF maturation mean time of 58 days (range 37-168 days) with one serious procedure-related adverse event and five minor procedure-related adverse events. 6 Several authors have noted a low risk of proximal radial artery access-related steal syndrome and reported more moderate AVF flow volume compared with AVFs based on the brachial artery. [7][8][9] The absence of a visible scar with pAVF is particularly important to many patients for aesthetic reasons.…”

Section: Discussionmentioning

confidence: 99%

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Clinical hemodialysis experience with percutaneous arteriovenous fistulas created using the Ellipsys® vascular access system

Hebibi

Achiche

Franco

et al. 2019

Hemodialysis International

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Introduction: The aim of this study is to report our clinical hemodialysis experience using a percutaneous arteriovenous fistula (pAVF) created with the Ellipsys® vascular access system. This pAVF device creates a permanent AVF anastomosis between the proximal radial artery (PRA) and the deep communicating vein (DCV) in the proximal forearm. Methods: The medical records of all patients with a pAVF were retrospectively reviewed. The clinical data analyzed included reliability of pAVF use, quality of dialysis, rate and success of puncture, and pAVF related complications, along with incidence of subsequent interventions. Findings: Between May 2017 and November 2018, 34 patients had a pAVF created with technical success in 33 patients (97%). Twenty‐eight out of 34 (82%) patients had successful two‐needle cannulation within 10 days to 6 weeks after pAVF creation. The mean Kt/v was 1.6 (1.2‐2) and the average recirculation was 10%. Fifteen patients (44%) needed no further access intervention. Twelve patients (35%) required an additional procedure to assist maturation of the pAVF in order to facilitate puncture. The average blood flow measured at the brachial artery, before the first cannulation, was 850 ml/min. From causes unrelated to the procedure, four patients died during the follow‐up study. Two patients required revision to a surgical AVF. None of the pAVFs developed aneurysmal degeneration steal syndrome, or high access flow related issues. Discussion: The Ellipsys® pAVF offers a safe and functional vascular access for hemodialysis. Advantages included prompt access maturation, avoidance of high flow AVFs, and a simple nonsurgical procedure with high patient satisfaction. Functional outcomes are equivalent and likely better than surgical fistulas. There appears to be less aneurysmal degeneration and need for future re‐intervention. Objective dialysis parameters indicate excellent quality of hemodialysis for the patient.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical hemodialysis experience with percutaneous arteriovenous fistulas created using the Ellipsys® vascular access system

Hebibi

Achiche

Franco

et al. 2019

Hemodialysis International

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“…Vascular Access Management for Haemodialysis: A Value-Based Approach from NephroCare… DOI: http://dx.doi.org /10.5772/intechopen.84987 Third, assess clinical value of minimally invasive procedures such as percutaneous creation of VA [158,159].…”

Section: Va Future Outlookmentioning

confidence: 99%

Vascular Access Management for Haemodialysis: A Value-Based Approach from NephroCare Experience

Canaud¹,

Ponce²,

Parisotto³

et al. 2019

Vascular Access Surgery - Tips and Tricks

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A good functioning vascular access (VA) is a prerequisite to obtain a successful dialysis treatment. This chapter reviews VA management in advanced chronic kidney disease (CKD) patients drawn from the experience of a large network dialysis care provider with the following sections: overview on VA management in advanced CKD that follows patient pathway and patient profile, current practice patterns in line with best clinical practices; VA creation addressing crucial themes: when and what type of VA to construct, how to assess patient pre-emptively, how to proceed for the construction and monitoring to prevent early failures and complications; VA management with particular focus on clinical monitoring, surveillance and interventional procedures required to preserve patency and functionality of VA; the often-forgotten patient perspective is VA usage. What information to share, how to proceed for preventing pain, and fears related with VA needling? What should patients know about their VA and how to manage in daily life? Competences, skills and responsibilities of nursing staff when using and managing VA; and future of VA in terms of innovative concept for creating and maintaining VA conduits in dialysis patients.

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“…Two new devices have been described for creating a percutaneous AVF (pAVF) using different mechanisms and techniques. [5][6][7][8][9] We describe our experience with one of these devices, using pressure and thermal resistance energy (thermal resistance anastomosis device [TRAD]) to create an arteriovenous anastomosis with fusion of the arterial and venous walls between the proximal radial artery (PRA) and the deep communicating vein (DCV) in the proximal part of the forearm.…”

mentioning

confidence: 99%

Early results of percutaneous arteriovenous fistula creation with the Ellipsys Vascular Access System

Mallios

Jennings

Boura

et al. 2018

Journal of Vascular Surgery

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Successful pAVFs with proximal radial artery inflow were created with excellent initial results regarding technical success, patency, and safety. Advantages include avoidance of a surgical incision, short procedure times, good acceptance by patients, prompt access maturation, moderate flow, and low-pressure access, with possible reduction of risk for ischemic complications. Avoidance of vessel manipulation and side branch ligation might reduce risk of thrombosis and improve long-term patency and reduce need for further interventions. These early findings need to be confirmed in larger and longer follow-up studies.

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Percutaneous Creation of an Arteriovenous Fistula for Hemodialysis Access

Cited by 90 publications

References 30 publications

Clinical hemodialysis experience with percutaneous arteriovenous fistulas created using the Ellipsys® vascular access system

Clinical hemodialysis experience with percutaneous arteriovenous fistulas created using the Ellipsys® vascular access system

Vascular Access Management for Haemodialysis: A Value-Based Approach from NephroCare Experience

Early results of percutaneous arteriovenous fistula creation with the Ellipsys Vascular Access System

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