Patency and functionality of radiocephalic arteriovenous fistulas with an external support device (VasQ™): Real-world single-center experience

Abstract

Background: The VasQTM device was designed to improve the outcome of arteriovenous fistulae by optimizing the hemodynamics of the flow in the juxta-anastomotic region of the arteriovenous fistulae through tailored external support. The aim of the study was to evaluate the impact of the VasQ on outcome of radiocephalic arteriovenous fistulae in a real-world setting. Methods: This was a single-center, retrospective analysis of patients with either fistula creation before or after dialysis initiation with implantation of the VasQ device during creation of end-to-side radiocephalic arteriovenous fistulae between June 2018 and May 2019. The flow rate and vein diameter were evaluated intraoperatively, at discharge within 48 h postprocedure and at a follow-up of 1, 3, 6, 9, and 12 months. Results: Thirty-three VasQ devices were implanted during 33 radiocephalic arteriovenous fistula procedures. The study population comprised mostly of men, with an average age of 66 years. Mean intraoperative flow was 428 mL/min (range: 130–945). All patients were discharged with patent arteriovenous fistulae and mean fistula flow of 740 mL/min (range: 230–1300 mL/min). The primary patency was 100% and 79% at 3 and 6 months, respectively. Cumulative/secondary patency was 100% and 90% at 3 and 6 months, respectively. Conclusion: Data presented here suggest that the VasQ device has the potential to provide benefit to the functionality of radiocephalic arteriovenous fistulae.

Multicenter European real-world utilization of VasQ anastomotic external support device for arteriovenous fistulae

“…AVF creation with the use of VasQ™ was performed as previously described and according to the surgeons' standard practice 5,6 . Typically, the procedures using the VasQ TM device do not differ from those created without the device: the device can be used in all patients except of those with known nitinol allergy, and the length of the incisions are not affected by the device.…”

“…VasQ TM device has recently demonstrated benefits in reducing the risk of stenosis while promoting outward (dilative) remodeling of the outflow vein for in a set of brachiocephalic AVFs (BCAVF) 4,5 . Similar results were observed for radiocephalic AVFs (RCAVF) supported by VasQ™ in a single-center, retrospective comparative study, showing consistent outcomes for different types of AVFs 4,5 .…”

New Devices and Technologies for Hemodialysis Vascular Access: A Review

“…The global epidemic of CKD and kidney failure has ignited several interesting developments that are in the pipeline. Projects that have progressed to clinical studies include a 1) pneumatic compression device (Fist Assist [Fist Assist Devices, LLC]) to promote AVF maturation 44 ; 2) the VasQ (Laminate Medical Technologies) device to improve primary AVF maturation, which regulates blood flow by constraining and shaping the fistula and reinforcing and shielding the perianastomotic vein against high pressure, wall tension, and flow levels 45,46 ; 3) the av-Guardian (Advent Access) vascular access system to guide cannulating needles into the AVF 47 ; and 4) BioNanomatrix gel (Endomimetics), designed to prevent intraluminal tissue growth and prevent stenosis in the vein segment of the AVF to promote the AVF maturation process and reduce the primary failure rate. 48 Summary After several decades of dormancy, innovations in HD vascular access have been reinvigorated.…”

Implanted blood vessel external support device (VasQ™) for creation of hemodialysis arteriovenous fistula: A single-center experience

“…Overall, our preliminary results are encouraging, especially for RCAVFs, even if with a small study population (6/16 patients). Recently, Shahverdyan et al 18 reported the impact of the VasQ on outcome of RCAVFs in a retrospective study: AVFs primary and secondary patency at 6 months were 79% and 90%, respectively; successful maturation was achieved in 88% (29/33). This is of note, because RCAVFs are associated with lower patency and maturation rates than BCAVFs.…”