Annie Collum, BSN, RN is the RIA Senior Manager, Physician Liaison in Denver, Colorado
Benefits of Percutaneous Fistula Creation for Hemodialysis Access
From the Journal of Vascular and Interventional Radiology comes an article on the benefits of percutaneous fistula creation for hemodialysis access. This is something we do at RIA Endovascular and has proven very successful. You can learn more here: riaendovascular.com/2019/04/22/new-dialysis-fistula-procedure
Long Term Results from The Pivotal Multicenter Trial of Ultrasound Guided Percutaneous Arteriovenous Fistula Creation for Hemodialysis Access
Jeffrey E. Hull, M.D., William C. Jennings, M.D., Randy I. Cooper, M.D., Rajeev Narayan, M.D., Neghae Mawla, M.D., Meredith D. Decker, MS
Published:June 01, 2022
To report the five-year results from the Pivotal Multicenter Trial of Ultrasound Guided Percutaneous
Arteriovenous Fistula (pAVF) Creation for Hemodialysis Access.
Materials and Methods:
Retrospective review of 107 intent-to-treat (ITT) patients from the pivotal trial provided a long-term followup population (LTP) of 85 patients followed a median 50 months (range 12-60). Data evaluated in the LTP group were fistula maturation and use, secondary procedures, and complications. Kaplan-Meier
analysis of primary, primary assisted, cumulative patency, and functional patency (time from two-needle
to abandonment) were performed for the ITT population.
In the LTP 99% (84/85) of fistulas were mature with 99% (78/79) of patients requiring hemodialysis using their pAVF. Sustained fistula use (two-needle cannulation at prescribed rate, 2/3 sessions) was achieved in 92% (78/85) of patients, with seven patients never using their pAVF because not on dialysis (n=4), peritoneal dialysis (n=2), and refusing to use fistula (n=1). Fistula maintenance was required in 31.8% (27/85) of patients and included fistula dysfunction (21.2%), thrombosis (5.9%), cannulation injury (12.9%), and arm swelling (4.7%). The number of procedures performed per patient per year (PPPY) to maintain function and patency was 0.32 (91/288) for years 2-5. The cumulative patency was 89.5%, 88.4%, 88.4%, 85.6%, and 82.0% years 1-5, respectively. The functional patency was 91.8% at the end of the study. There were no major complications related to pAVF during long-term follow-up
Conclusion: Percutaneous fistulae have provided clinically effective and durable access for hemodialysis with low complications. Continued use and evaluation of pAVF is warranted.
To read the complete journal article go here: https://www.jvir.org/article/S1051-0443(22)00974-5/fulltext
(photo: Percutaneous AV Fistula creation using WavelinQ™)
Hull JE, Jennings WC, Cooper RI, Narayan R, Mawla N, Decker MD, Long
Term Results from The Pivotal Multicenter Trial of Ultrasound Guided Percutaneous Arteriovenous
Fistula Creation for Hemodialysis Access, Journal of Vascular and Interventional Radiology (2022), doi: