Using two‐holed needles for both arterial and venous accesses to the arteriovenous fistula to improve flow during hemodialysis

Abstract

This prospective study compared methods using both arterial and venous needles with back eyes with those using only arterial needle with back eye for arteriovenous fistula cannulation. Sixty‐one patients receiving hemodialysis (HD) via an arteriovenous fistula were evaluated. All patients underwent arteriovenous fistula puncture using only arterial needle with back eye in first 3 months and both arterial and venous needles with back eyes in following 3 months. Arterial and venous pressures, blood flow velocities, total blood volume cleared, and Kt/V values were compared. Mean blood flow velocity, arterial pressure, Kt/V, and cleared total blood volume values were higher and venous pressure was lower in patients who underwent cannulation using both needles with back eyes than in those with only the arterial needle with back eye. For arteriovenous fistula cannulation, using both arterial and venous needles with back eyes provides adequate HD more successfully.

Effect of needle bevel position in arteriovenous fistula cannulation and bleeding during hemodialysis

“…During AVF needle puncture, issues such as needle entry direction, needle size, back eye, and needle type have been discussed in earlier studies [7,15,16]. Another concern in HD cannulation is the bevel position of the needles used during AVF puncture, which is seldom discussed in the literature but is crucial as it might affect the treatment.…”

“…The National Kidney Foundation (KDOQI), in its clinical practice guideline for vascular access in 2006, recommended that the AVF be cannulated with a 25° puncture angle and bevel-up needle position [5]. BD or BU types of needle puncture methods, used during cannulation, vary in different HD centers [6][7][8][9]. Additionally, the literature indicates that many centers frequently use the AVF puncture method with needle bevel-up position [6][7][8][9].…”

“…BD or BU types of needle puncture methods, used during cannulation, vary in different HD centers [6][7][8][9]. Additionally, the literature indicates that many centers frequently use the AVF puncture method with needle bevel-up position [6][7][8][9]. However, few reports have compared AVF cannulation methods (bevel-up or bevel-down punctures) with various clinical aspects.…”

“…However, few reports have compared AVF cannulation methods (bevel-up or bevel-down punctures) with various clinical aspects. Additionally to the fact that many HD centers prefer BU puncture in AVF cannulation, few studies have investigated whether BD puncture has an advantage concerning clinical aspects over the BU puncture [6][7][8][9][10][11]. We examined some of these reports.…”