Arteriovenous fistula formation with adjuvant endovascular maturation

Thomas, Shannon D.; Sideris, Anders; Narroway, Harry; McLachlan, Rohan; Robertson, Cameron; Crowe, Phillip; Varcoe, Ramon L.

doi:10.1016/j.jvs.2021.08.072

Cited by 9 publications

(5 citation statements)

References 32 publications

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“…The results were similar to those described in the professor Chen’s report [ 12 ]. Yet, at 12 months, the primary patency rate was much lower than previous results reported in the recent years [ 13 ]. This may be due to the fact that previous studies employed techniques like JXAS stenting, cannulation zone stenting and drug coated balloon angioplasty, while our research merely used plain balloon angioplasty.…”

Section: Discussioncontrasting

confidence: 60%

Pull-through technique through antegrade radial artery puncture without sheath insertion in balloon-assisted radiocephalic arteriovenous fistulas maturation

Yin,

Zhang,

2024

BMC Nephrol

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Purpose The aim of this study was to investigate the effectiveness and safety of the pull-through technique through antegrade radial artery puncture without sheath insertion in balloon-assisted radiocephalic AVF maturation. Methods We retrospective studied a total of 62 patients with immature radiocephalic AVF, who received balloon-assisted maturation in our hospital. 15 patients received pull-through technique through radial artery without sheath insertion and 47 patients received treatment through a regular venous approach. Results The success rate of pull-through technique group and control group was 86.7% (13 out of 15), 89.1% (41 out of 46) respectively. There was no significant difference between two groups (P > 0.05). In our study, there were 2 patients in the pull-through technique group and 3 patients in the control group, which had hematoma in the vein puncture site (P = 0.59). There were also no differences in the primary patency rate between two groups at 6 months and 12 months (76.9% vs 70.7%, 38.4% vs 41.5%, respectively, P > 0.05). Conclusion The pull-through technique through antegrade radial artery without sheath insertion in promoting radiocephalic AVF maturation is effective and safe.

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Section: Discussioncontrasting

confidence: 60%

Pull-through technique through antegrade radial artery puncture without sheath insertion in balloon-assisted radiocephalic arteriovenous fistulas maturation

Yin,

Zhang,

2024

BMC Nephrol

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“…Currently, doppler ultrasound has been shown to be an effective technique in monitoring fistula maturation and commonly used in clinical practice 17,18 .Access criteria for maturation or intervention in AVF have not yet been clearly defined. KDOQI guidelines suggest 14 that a fistulas should be evaluated to determine its suitability at 4-6 weeks after creation 15,19,20 .Does this imply that we may estimate AVF maturation based on ultrasound parameters at 4 weeks?…”

Section: Discussionmentioning

confidence: 99%

Nomogram-Based Prediction of the Risk of AVF Maturation :A Retrospective Study

Zhao,

Wang,

Wang

et al. 2024

Preprint

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Objective: Early identification of autogenous arteriovenous fistula (AVF) maturation failure among end stage renal disease (ESRD) is crucial since it will likely allow early intervention to improve AVF maturation rate and shorten the duration of catheter usage. The aim of this study was to develop a nomogram for predicting AVF maturity in ESRD patients and explore the optimal timing of intervention for promaturity. Methods: In this retrospective study, we assembled a retrospective cohort of 543 ESRD patients who had undergone AVF creation and routine follow-up at the Beijing Haidian Hospital (Haidian Section of Pecking University Third Hospital) between August 2018-and March 2022. A total of 532 subjects were randomly divided into the training cohort (389 cases) and the validation cohort (143 cases). In each cohort, the patients were divided into mature and non-mature groups according to whether arrived clinical or ultrasound criteria on three months after AVF creation. The timing of early intervention for non-maturation AVF was preliminarily discussed after a risk prediction nomogram for non-maturation in newly AVF creation was constructed. Results: Among the total of 532 patients included, 379 (73.24%) of whom achieved fistula maturation at 3 months postoperatively. We randomly divided the total study population using computer-generated randomization into a training cohort (n=389) and a validation cohort (n=143) in approximately a 7:3 ratio. For the training cohort, our study found that the anastomotic diameter (anas1), internal diameter of the anastomotic vein(V1), and brachial artery blood flow (F1) at 1 month postoperatively were associated with the maturity. We generated a maturation nomogram in the training cohort (area under the curve [AUC], 0.938 [95% confidence interval {CI}, 0.908-0.967]; sensitivity 0.911; specificity 0.856) and validated the model in the validation cohort (AUC, 0.927 [95% CI,0.879-0.975]; sensitivity 0.870; specificity 0.886). The calibration curve showed optimal agreement between nomogram prediction and actual observation. Conclusion: The nomogram can help clinicians identify the arteriovenous AVF maturation in ESRD patients. Our research also suggests that one month may be the optimal timing of non-maturity intervention for AVF.

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“…AVF surgery was performed on patients indicated for long-term HD by a vascular surgeon. The set inclusion criteria were age >18, ESKD with estimated glomerular filtration rate less than 20 mm/min/1.73m2, and patients posted for dialysis unit deemed long-term HD by a nephrologist [ 6 ]. The exclusion criteria were patients who didn't meet the inclusion criteria and those who denied consent.…”

Section: Methodsmentioning

confidence: 99%

“…Maturation time was defined by both clinical and duplex ultrasound methods, clinically maturation time is defined by time from the date of procedure to the date of the sixth consecutive dialysis with two needles; this criterion is especially true for patients with CVC [ 7 ], another definition is via the rule of 6s' describing at least 600 ml/min blood flow rate, 6 mm diameter cannulation zone, <6mm depth, and 6 cm length of cannulation zone [ 6 ].…”

Section: Methodsmentioning

confidence: 99%

Standardization of Pre-operative Evaluation to Improve the Outcome of Arteriovenous Fistula for Vascular Access of Hemodialysis: A Review of 700 Cases

Suryawanshi,

Dutta,

Ganduboina

et al. 2023

Cureus

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Background With the advent of COVID-19, mortality rates of end-stage kidney disease (ESKD) rose by 37% which makes its treatment an important part of healthcare. Arteriovenous fistula (AVF) is linked to higher patient survival rates. Cimino-Brescia fistula is the most effective vascular access technique, but it has a high rate of primary failure (PF) and a several-week maturation period before it can be used. The current study aims to verify the preoperative evaluation in improving survival among AVF patients. Methodology The current study is a retrospective analysis of the hospital database from Jan 2022 to July 2023, with patients of a mean age of 60.2 years. The sample size was around 700, including the patients indicated for long-term hemodialysis (HD) with an estimated GFR of less than 20 mm/min/1.73m². Following AVF surgery, post-operative outcomes, PF, and maturation time were considered. Results Among the 757 AVF procedures, 588 (82%) were new cases, and 112 (16%) had prior AVF history on the same side. PF was observed in 126 (18%) AVFs, while 574 (84%) achieved maturation. Age at surgery did not correlate with PF. Male sex and brachiocephalic AVF (BCAVF) had lower PF rates, while female gender, non-BCAVF, and vascular chronic kidney disease (CKD) were independent predictors. Proximal fistulas had a higher failure risk (32%). During surgery, the PF occurred six times more frequently in patients with veins and arteries under 2 mm and without a bruit. Conclusion AVF maturation aims to achieve a functional AVF for easy dialysis, requiring meticulous vein selection, doppler vascular mapping, and a standardized process to reduce PF rates. Factors determining PF include thrill and bruit, flow rates, and comorbidities. These findings can help clinicians make informed decisions and improve outcomes for patients undergoing fistula surgery.

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Arteriovenous fistula formation with adjuvant endovascular maturation

Cited by 9 publications

References 32 publications

Pull-through technique through antegrade radial artery puncture without sheath insertion in balloon-assisted radiocephalic arteriovenous fistulas maturation

Pull-through technique through antegrade radial artery puncture without sheath insertion in balloon-assisted radiocephalic arteriovenous fistulas maturation

Nomogram-Based Prediction of the Risk of AVF Maturation :A Retrospective Study

Standardization of Pre-operative Evaluation to Improve the Outcome of Arteriovenous Fistula for Vascular Access of Hemodialysis: A Review of 700 Cases

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