The Ellipsys Vascular Access System met primary safety and efficacy endpoint goals in the US pivotal trial.

No abstract

End-stage kidney disease patients who are candidates for surgical arteriovenous fistula creation commonly experience obstacles to a functional surgical arteriovenous fistula, including protracted wait time for creation, poor maturation, and surgical arteriovenous fistula dysfunction that can result in significant patient morbidity. The recent approval of two endovascular devices designed to create a percutaneous arteriovenous fistula enables arteriovenous fistula creation to be placed in the hands of interventionalists, thereby increasing the number of arteriovenous fistula providers, reducing wait times, and allowing the patient to avoid surgery. Moreover, current studies demonstrate that patients with percutaneous arteriovenous fistula experience improved time to arteriovenous fistula maturation. Yet, in order to realize the potential advantages of percutaneous arteriovenous fistula creation within our hemodialysis patient population, it is critical to select appropriate patients, ensure adequate patient and dialysis unit education, and provide sufficient instruction in percutaneous arteriovenous fistula cannulation and monitoring. In this White Paper by the American Society of Diagnostic and Interventional Nephrology, experts in interventional nephrology, surgery, and interventional radiology convened and provide recommendations on the aforementioned elements that are fundamental to a functional percutaneous arteriovenous fistula.

No abstract

Between 1978 and 1982, 1,200 patients underwent angiography following acute traumatic injury, and arterial injuries were detected in 182 cases (15.2%). Two-thirds of the cases were associated with penetrating trauma; half the injuries occurred in the pelvis or lower extremities. The most common and reliable sign of arterial injury was the presence of extraluminal contrast media. Other signs included occlusion, laceration, transection, arteriovenous fistula, intimal flap, and intraluminal thrombus. Luminal narrowing was difficult to interpret and resulted from a variety of causes, some of which do not require surgical intervention. Embolotherapy to control arterial bleeding was attempted in 79 patients (43%), and hemostasis was achieved in 69 of them (87%). Transcatheter closure was attempted in 19 of 34 arteriovenous fistulas, resulting in complete success in 15 cases and partial success in two.