One Unit's Experiences When Establishing Buttonhole Technique, Analysis of Reasons for Failure of Procedure: A Report

Abstract

The buttonhole technique of access of needle insertion into a single selected site in the arteriovenous fistula has proved to be a reliable alternative to older methods due to its overall low complication rates. Although the use of blunt needles improves the technique, the success rate of cannulation with these needles is difficult to predict. We analysed the short-term outcome of 16 patients receiving in-centre haemodialysis and compared clinical relevant parameters between patients with and without buttonhole technique failure. Our dialysis unit treats about 180 patients and is located in a tertiary hospital in Sao Paulo, Brazil. The variables as discussed in the paper were the same for both groups. The incidence of technique failure was 43.7%. Patients enrolled later in the study had a better buttonhole failure-free survival rates than patients enrolled at the beginning (p < 0.05). Patients' clinical characteristics did not predict the success rate of buttonhole tunnel tracks cannulation with blunt needles. This paper also reports on our successes and failures in buttonhole technique and gives some reasons and reflections for both.

Outcomes of Buttonhole and Rope‐ladder Cannulation Techniques in a Tropical Renal Service

“…However, it is rewarding to see that buttonhole sites are ‘seeing the test of time’ and that they have not failed as they have in other units (Galante et al . ). The Renal Service considers that the reported extra costs associated with buttonhole cannulation supplies (Ludlow ) are minimal compared to the cost of a central line necessitated by a traumatic cannulation with the rope‐ladder technique.…”

“…; Galante et al . ), although there are some suggestions that buttonhole cannulation could perhaps become the default technique (Murcutt ).…”

Buttonhole, "em casa de botão" ou "botoeira": uma técnica antiga redescoberta

“…In our recently published experience (Galante et al 3 ), the buttonhole technique showed to be a useful and efficient method, which, in theory, could be routinely used in all patients. Its main advantages are the possibility of using short-trajectory fistulas, the absence of aneurysm formation, decrease in painful sensations during punctures, prolonging the fistula service life and decreasing bleeding and hematomas, improving the esthetical aspect.…”

A Systematic Review of Buttonhole Cannulation Practices and Outcomes

“…Studies were excluded for the following reasons: opinion piece or review with no usable original data (N = 18) (7-23), home and in-center patient data combined and reported in aggregate (N = 3) (24-26), and no patient-important outcomes reported (N = 2) (27,28). Twenty-two full-text articles were therefore included in this review (2)(3)(4)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47). We also identified four ASN conference abstracts published between 2009 and 2011 (48)(49)(50)(51).…”