Article Sidebar
Downloads
Metrics
Main Article Content
Abstract
Introduction: Arteriovenous fistula is considered the priority access for hemodialysis patients. In recent years, an alternative to the surgical creation of an arteriovenous fistula has been chosen, such as the endovascular arteriovenous fistula. This new technology involves a less aggressive and non-surgical approach.
Objective: To describe the preliminary data from our unit after the implementation of this novel system, as well as the nurse involvement.
Material and Method: Retrospective descriptive analysis of the endovascular AVFs performed in five patients using the percutaneous technique. The characteristics of the patients, the endovascular AVFs performed and the difficulty of puncture (VAS scale) were considered.
Results: Mean age was 63(47-77) years, 100% male, dialysing with a tunneled catheter, 4 of the patients had at least one unsuccessful surgical arteriovenous fistula. Endovascular AVF creation was successful in 4 of the 5 patients, all with radio-radial location. There were no complications during the procedure. Of the 4 endovascular AVFs 3 required subsequent endovascular intervention for maturation. The median maturation time was 4.5 (4-5) months; all 4 remained permeable at 1 year.
The median difficulty score by 9 experienced nurses was for initial puncture: 7; after 1 month: 5 and compared to surgical AVFs: 5.
Conclusions: Endovascular AVF was a minimally invasive procedure with lower patient impact, high initial success, but required subsequent endovascular intervention for maturation. Difficulty of puncture was higher initially. The absence of scar as a baseline meant a more thorough exploration.
Keywords
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Author copyright notice
© Authors grant the publisher the non-exclusive licence to publish the work and consent to its use and distribution under the Creative Commons Attribution - NonCommercial 4.0 International (CC BY-NC 4.0) licence. Read the licensing information and the legal text here. This must be expressly stated wherever necessary.
References
- Ibeas J, Roca-Tey R, Vallespín J, Moreno T, Moñux G, Martí-Monrós A, et al. Guía Clínica Española del Acceso Vascular para Hemodiálisis. Nefrologia 2017 Jan 1;37:1–191. DOI: https://doi.org/10.1016/j.nefro.2017.11.004
- Brescia MJ, Cimino JE, Appel K, Hurwich BJ. Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula. N Engl J Med [Internet]. 1966;275(20):1089—1092. Disponible en: https://doi.org/10.1056/NEJM196611172752002. DOI: https://doi.org/10.1056/NEJM196611172752002
- Hull JE, Jennings WC, Cooper RI, Waheed U, Schaefer ME, Narayan R. The Pivotal Multicenter Trial of Ultrasound-Guided Percutaneous Arteriovenous Fistula Creation for Hemodialysis Access. J Vasc Interv Radiol [Internet]. 2018 Feb 1 [cited 2022 Jun 23];29(2):149-158.e5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29275056/. DOI: https://doi.org/10.1016/j.jvir.2017.10.015
- Lok CE, Rajan DK, Clement J, Kiaii M, Sidhu R, Thomson K, et al. Endovascular Proximal Forearm Arteriovenous Fistula for Hemodialysis Access: Results of the Prospective, Multicenter Novel Endovascular Access Trial (NEAT). Am J Kidney Dis 2017 Oct 1;70(4):486–97. DOI: https://doi.org/10.1053/j.ajkd.2017.03.026
- Mallios A, Nelson PR, Franco G, Jennings WC. Creating percutaneous radiocephalic arteriovenous fistulas at the wrist. J Vasc Access [Internet]. 2021 Mar 1 [cited 2022 Jun 23];22(2):299–303. Disponible en: https://journals.sagepub.com/doi/10.1177/1129729820933737. DOI: https://doi.org/10.1177/1129729820933737
- Berland T, Clement J, Inston N, Kreienberg P, Ouriel K, Bala S, et al. Percutaneous arteriovenous fistula creation with the 4F WavelinQ EndoAVF System. J Vasc Surg 2022 Mar 1;75(3):1038-1046.e3. DOI: https://doi.org/10.1016/j.jvs.2021.09.025
- WavelinQTM EndoAVF System - Rethink Fistula Creation - WavelinQ [Internet]. [cited 2022 Jun 4]. Disponible en: https://wavelinq.bd.com/.
- Hebibi H, Achiche J, Franco G, Rottembourg J. Clinical hemodialysis experience with percutaneous arteriovenous fistulas created using the Ellipsys® vascular access system. Hemodial Int [Internet]. 2019/03/01. 2019 Apr;23(2):167–72. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30821894. DOI: https://doi.org/10.1111/hdi.12738
- Lok CE, Rajan DK. KDOQI 2019 Vascular Access Guidelines: What Is New. Semin Intervent Radiol 2022;39(1):3–8. DOI: https://doi.org/10.1055/s-0041-1740937
- Dawoud D, Lok CE, Waheed U. Recent Advances in Arteriovenous Access Creation for Hemodialysis: New Horizons in Dialysis Vascular Access. Adv Chronic Kidney Dis 2020;27(3):191–8. DOI: https://doi.org/10.1053/j.ackd.2020.02.002
- Rajan DK, Ebner A, Desai SB, Rios JM, Cohn WE. Percutaneous creation of an arteriovenous fistula for hemodialysis access. J Vasc Interv Radiol [Internet]. 2015 [cited 2022 Jun 23];26(4):484–90. Disponible en: https://pubmed.ncbi.nlm.nih.gov/25805537/. DOI: https://doi.org/10.1016/j.jvir.2014.12.018
- Radosa CG, Radosa JC, Weiss N, Schmidt C, Werth S, Hofmockel T, et al. Endovascular Creation of an Arteriovenous Fistula (endoAVF) for Hemodialysis Access: First Results. Cardiovasc Interv Radiol [Internet]. 2017 [consultado 4 Jul 2022];40(10):1545–51. Disponible en: https://link.springer.com/article/10.1007/s00270-017-1750-x. DOI: https://doi.org/10.1007/s00270-017-1750-x
- Kitrou PM, Balta L, Papachristou E, Papasotiriou M, Katsanos K, Theofanis M, et al. Percutaneous Arteriovenous Fistula Creation with the WavelinQ 4-French EndoAVF System: A Single-Center Retrospective Analysis of 30 Patients. J Vasc Interv Radiol 2022;33(1):33–40. DOI: https://doi.org/10.1016/j.jvir.2021.09.021
- Yan Wee IJ, Yap HY, Tang TY, Chong TT. A systematic review, meta-analysis, and meta-regression of the efficacy and safety of endovascular arteriovenous fistula creation. J Vasc Surg [Internet]. 2020 [consultado 4 Jul 2022];71(1):309-317.e5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31564584/. DOI: https://doi.org/10.1016/j.jvs.2019.07.057
- Molina Mejías P, Liébana Pamos B, Moreno Pérez Y, Arribas Cobo P, Rodríguez Gayán P, Díaz de Argote P, et al. Aportación de la ecografía realizada por enfermería a la exploración del acceso vascular. Enfermería Nefrológica [Internet]. 2017 [consultado 4 Jul 2022];20(3):241–5. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2254-28842017000300241&lng=es&nrm=iso&tlng=es. DOI: https://doi.org/10.4321/S2254-28842017000300007
References
Ibeas J, Roca-Tey R, Vallespín J, Moreno T, Moñux G, Martí-Monrós A, et al. Guía Clínica Española del Acceso Vascular para Hemodiálisis. Nefrologia 2017 Jan 1;37:1–191. DOI: https://doi.org/10.1016/j.nefro.2017.11.004
Brescia MJ, Cimino JE, Appel K, Hurwich BJ. Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula. N Engl J Med [Internet]. 1966;275(20):1089—1092. Disponible en: https://doi.org/10.1056/NEJM196611172752002. DOI: https://doi.org/10.1056/NEJM196611172752002
Hull JE, Jennings WC, Cooper RI, Waheed U, Schaefer ME, Narayan R. The Pivotal Multicenter Trial of Ultrasound-Guided Percutaneous Arteriovenous Fistula Creation for Hemodialysis Access. J Vasc Interv Radiol [Internet]. 2018 Feb 1 [cited 2022 Jun 23];29(2):149-158.e5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29275056/. DOI: https://doi.org/10.1016/j.jvir.2017.10.015
Lok CE, Rajan DK, Clement J, Kiaii M, Sidhu R, Thomson K, et al. Endovascular Proximal Forearm Arteriovenous Fistula for Hemodialysis Access: Results of the Prospective, Multicenter Novel Endovascular Access Trial (NEAT). Am J Kidney Dis 2017 Oct 1;70(4):486–97. DOI: https://doi.org/10.1053/j.ajkd.2017.03.026
Mallios A, Nelson PR, Franco G, Jennings WC. Creating percutaneous radiocephalic arteriovenous fistulas at the wrist. J Vasc Access [Internet]. 2021 Mar 1 [cited 2022 Jun 23];22(2):299–303. Disponible en: https://journals.sagepub.com/doi/10.1177/1129729820933737. DOI: https://doi.org/10.1177/1129729820933737
Berland T, Clement J, Inston N, Kreienberg P, Ouriel K, Bala S, et al. Percutaneous arteriovenous fistula creation with the 4F WavelinQ EndoAVF System. J Vasc Surg 2022 Mar 1;75(3):1038-1046.e3. DOI: https://doi.org/10.1016/j.jvs.2021.09.025
WavelinQTM EndoAVF System - Rethink Fistula Creation - WavelinQ [Internet]. [cited 2022 Jun 4]. Disponible en: https://wavelinq.bd.com/.
Hebibi H, Achiche J, Franco G, Rottembourg J. Clinical hemodialysis experience with percutaneous arteriovenous fistulas created using the Ellipsys® vascular access system. Hemodial Int [Internet]. 2019/03/01. 2019 Apr;23(2):167–72. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30821894. DOI: https://doi.org/10.1111/hdi.12738
Lok CE, Rajan DK. KDOQI 2019 Vascular Access Guidelines: What Is New. Semin Intervent Radiol 2022;39(1):3–8. DOI: https://doi.org/10.1055/s-0041-1740937
Dawoud D, Lok CE, Waheed U. Recent Advances in Arteriovenous Access Creation for Hemodialysis: New Horizons in Dialysis Vascular Access. Adv Chronic Kidney Dis 2020;27(3):191–8. DOI: https://doi.org/10.1053/j.ackd.2020.02.002
Rajan DK, Ebner A, Desai SB, Rios JM, Cohn WE. Percutaneous creation of an arteriovenous fistula for hemodialysis access. J Vasc Interv Radiol [Internet]. 2015 [cited 2022 Jun 23];26(4):484–90. Disponible en: https://pubmed.ncbi.nlm.nih.gov/25805537/. DOI: https://doi.org/10.1016/j.jvir.2014.12.018
Radosa CG, Radosa JC, Weiss N, Schmidt C, Werth S, Hofmockel T, et al. Endovascular Creation of an Arteriovenous Fistula (endoAVF) for Hemodialysis Access: First Results. Cardiovasc Interv Radiol [Internet]. 2017 [consultado 4 Jul 2022];40(10):1545–51. Disponible en: https://link.springer.com/article/10.1007/s00270-017-1750-x. DOI: https://doi.org/10.1007/s00270-017-1750-x
Kitrou PM, Balta L, Papachristou E, Papasotiriou M, Katsanos K, Theofanis M, et al. Percutaneous Arteriovenous Fistula Creation with the WavelinQ 4-French EndoAVF System: A Single-Center Retrospective Analysis of 30 Patients. J Vasc Interv Radiol 2022;33(1):33–40. DOI: https://doi.org/10.1016/j.jvir.2021.09.021
Yan Wee IJ, Yap HY, Tang TY, Chong TT. A systematic review, meta-analysis, and meta-regression of the efficacy and safety of endovascular arteriovenous fistula creation. J Vasc Surg [Internet]. 2020 [consultado 4 Jul 2022];71(1):309-317.e5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31564584/. DOI: https://doi.org/10.1016/j.jvs.2019.07.057
Molina Mejías P, Liébana Pamos B, Moreno Pérez Y, Arribas Cobo P, Rodríguez Gayán P, Díaz de Argote P, et al. Aportación de la ecografía realizada por enfermería a la exploración del acceso vascular. Enfermería Nefrológica [Internet]. 2017 [consultado 4 Jul 2022];20(3):241–5. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2254-28842017000300241&lng=es&nrm=iso&tlng=es. DOI: https://doi.org/10.4321/S2254-28842017000300007