Venous Window Needle Guide for deep vessels and difficult arteriovenous fistula cannulation

Abstract

The Venous Window Needle Guide (VWINGTM) has recently been proposed for patients with difficult arteriovenous fistula (AVF) access for hemodialysis due to deep vessels or other cannulation-related problems. This totally subcutaneous titanium device is sutured onto the upper wall of the matured fistula and may facilitate cannulation by the button-hole technique. We describe our initial experience with nine implants in six patients with a cumulative followup of 83 months, and make some experience-based technical suggestions for implant and surveillance radiological imaging. The indication for implantation was deep vessel, previous failure of cannulation or unsuitable site for direct cannulation. No infectious complications were observed during follow-up and proper blood flow was constantly achieved. Some difficulties were occasionally encountered with regard to cannulation; nonetheless, patient satisfaction was not significantly affected. VWING seems to be an interesting option in some patients provided that surgical implantation is carefully carried out and preventive measures against infections are strictly observed.

Successful 8-year use of Venous Window Needle Guide for deep arteriovenous fistula cannulation

“…The very initial Italian experience was carried out at our center and showed promising results. 7 We are here in presenting the case of a patient who is currently using the same VWING device after 8 years.…”