Use of the BioHole™ device for the creation of tunnel tracks for buttonhole cannulation of fistula for hemodialysis

Marticorena, Rosa; Hunter, Joyce; MacLeod, Stephen; Petershofer, Elizabeth J; Kashani, Mina; Cruz, Julia E. de la; Cook, Ramona; Dacoiris, Niki; McFarlane, Phil; Goldstein, Marc B.; Donnelly, Sandra

doi:10.1111/j.1542-4758.2010.00506.x

Cited by 27 publications

(22 citation statements)

References 7 publications

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“…Note that some, but not all, BH protocols include antibiotic prophylaxis. 20,21 The BH technique is not recommended for all patients and is contraindicated in patients with arteriovenous grafts (AVGs). In North America and Australasia, the BH technique is considered a relative contraindication for newly created AVFs because the fistula is undergoing dynamic changes that influence the BH tracts; however, this practice is not consistent globally.…”

Section: Vascular Access In Home Hemodialysismentioning

confidence: 99%

The care and keeping of vascular access for home hemodialysis patients

Faratro

Jeffries

Nesrallah

et al. 2015

Hemodialysis International

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Creating and maintaining a healthy vascular access is a critical factor in successful home hemodialysis (HD). This article aims to serve as a "how-to manual" regarding vascular access issues for both patients and health-care providers in a home HD program. This document outlines cannulation options for patients with arteriovenous access and describes troubleshooting techniques for potential complications; strategies are suggested to help patients overcome fear of cannulation and address problems associated with difficult cannulation. Technical aspects of central venous catheter care, as well as a guide to troubleshooting catheter complications, are covered in detail. Monitoring for access-related complications of stenosis, infection, and thrombosis is a key part of every home HD program. Key performance and quality indicators are important mechanisms to ensure patient safety in home HD and should be used during routine clinic visits.

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Section: Vascular Access In Home Hemodialysismentioning

confidence: 99%

The care and keeping of vascular access for home hemodialysis patients

Faratro

Jeffries

Nesrallah

et al. 2015

Hemodialysis International

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“…The peg remains in place between dialysis sessions and allows a tissue tunnel tract to form within approximately 14 days. Interestingly, no episodes of bacteremia have been reported in one study with up to a year's followup (14) or in two studies with 3 or fewer months' follow-up (23,24). Of note, all patients in these studies had established buttonhole tracts within 14 days.…”

mentioning

confidence: 94%

Should Buttonhole Cannulation Be Discontinued?

Moist

Nesrallah

2014

Clinical Journal of the American Society of Nephrology

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The arteriovenous fistula remains the preferred type of vascular access because of its higher patency and lower infection rates (1). Cannulation of the fistula remains a challenge for patients, caregivers, and nurses, often resulting in increased pain, stress, and vessel injury. The use of rotating puncture sites along the entire length of the fistula, or rope-ladder cannulation (RLC), was intended to heal the site and prevent hematoma, stenosis, infection, and pseudoaneurysm. Constant site needling or buttonhole cannulation (BHC) was introduced in the 1970s to address cannulation of short fistula segments (2). The technique is based on repeated sharp needle insertion into the same site, preferably by a single cannulator, at the same angle over the course of six to nine hemodialysis sessions. This produces a scar tissue tract across the vein wall, which can subsequently be cannulated with blunt needles.The initial observational studies of BHC, many of which were retrospective, reported lower rates of hematoma and infiltration injury, less needling time (2,3), and, importantly, less pain (3-7). BHC was adopted by many home dialysis programs for its ease of cannulation and decreased training time, as well as in-center units, with support from the National Kidney Foundation's guidelines on vascular access (1) and promotion as the preferred type of cannulation by the United Kingdom Renal Association (8).The recent reporting of increased infection rates (4,6,9-11) with the use of BHC and debate as to its benefit in reducing pain (9,(11)(12)(13)(14) and improving patency (15) has tempered its use in many units and calls into question whether BHC should be used at all. Before addressing this question, it is important to review the complete body of evidence, the study population (particularly differentiating home or in-center patients), outcomes, follow-up, and the specifics of the buttonhole technique. Recent systematic reviews of both in home and in-center dialysis (16) and intensive dialysis (17), as well as a narrative review (18), highlight the concerns regarding observational and crossover study designs, short follow-up, operator dependency, and differences in the BHC technique. These reviews highlight the ongoing uncertainty surrounding the benefits and risks of BHC (14,19).In this issue of CJASN, Muir at al. (20) report on a retrospective, single-center experience comparing BHC to RLC in a home hemodialysis population, accompanied by a systematic review of the related literature. The study reports a significant 3-fold increase in total fistula-related infections/1000 fistula-days in the BHC cohort (0.39 events) compared with the RLC cohort (0.10 events), with little change in the effect size after adjustment for differences in populations. The rate of systemic fistula infections is more difficult to interpret because events rates were low and results were not reported as per 1000 fistula-days, with different reporting periods: 2003 to mid-2004 for RLC and 2004-2009 for BHC. In addition, interpretation of the rat...

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“…The pain and discomfort of frequent needle punctures can be reduced by special methods such as the buttonhole technique (Marticorena et al 2011). However, the vascular access remains a vulnerable interface between the extracorporeal and the cardiovascular system.…”

Section: Introductionmentioning

confidence: 99%