Long Term Results of a Comparative Study of Percutaneous and Surgically Created Proximal Forearm Arteriovenous Fistulae.

Objective: This retrospective, single centre, comparative effectiveness study aimed to compare the long term outcomes of percutaneous arteriovenous fistulae (pAVF) and surgically created arteriovenous fistulae (sAVF) created in the proximal forearm for haemodialysis access.

Methods: Data were reviewed from a prospectively maintained database on patients who underwent pAVF or sAVF creation from September 2017 to September 2023. A total of 217 pAVFs (61 WavelinQ and 156 Ellipsys) and 158 sAVFs were analysed.

Novel classification of proximal forearm perforator vein in the planning and creation of percutaneous and surgical Gracz-type arteriovenous fistulae.

Background: The perforator vein determines whether it is feasible to create a percutaneous (pAVF) or surgical "Gracz-type" arteriovenous fistula (sAVF). Creating a standard anatomic classification of the antecubital region is beneficial to both the selection of the appropriate device and/or procedure and technical outcomes. Accordingly, an analysis of a large cohort of patients undergoing pAVF/sAVF was performed, focusing on perforator vein anatomical suitability, and a novel anatomical classification of the antecubital region was developed and proposed.

Gracz fistula is a feasible option after two failed percutaneous arteriovenous fistulae.

Two devices for the creation of an endovascular percutaneous (pAVF) endovascular (endoAVF) arteriovenous fistulae (AVF) are available: the Ellipsys and the WavelinQ-4F systems. The main difference is the location of the anastomosis, making it feasible to use both pAVFs and surgical Gracz-type AVF in an algorithm sequence. A 66-year-old male patient with end-stage kidney disease and HIV was referred for a creation of a dialysis access after failed peritoneal dialysis.

Comparison of Ellipsys Percutaneous and Proximal Forearm Gracz-Type Surgical Arteriovenous Fistulas.

Rationale & Objective: Percutaneous arteriovenous fistulas (AVF) are created by establishing a proximal forearm anastomosis and offer a safe and reliable vascular access. This study compares the Ellipsys percutaneous AVF with a proximal forearm Gracz-type surgical AVF, chosen for comparison as it is constructed at the same anatomical site.

Study Design: Retrospective study of prospectively collected clinical data.

The past and the future of vascular access surgery: Creation of percutaneous arteriovenous fistula using Ellipsys vascular access system in a patient with previous ipsilateral Scribner-shunt.

Background: Sixty years after the first description of Scribner-shunt, and 54 years after publication of the first radio-cephalic arterio-venous fistula (AVF), endovascular percutaneous AVF (pAVF) was introduced. We report a successful case of Ellipsys-pAVF creation and use for hemodialysis in a patient with a previous ipsilateral Scribner-shunt.

Case: A 72-year old female patient with chronic kidney disease (CKD), previous right-sided Scribner-shunt and kidney transplant, underwent a successful creation of right-sided Ellipsys-pAVF.

AV fistula creation in paediatric patients: outcome is independent of demographics and fistula type reducing usage of venous catheters.

Purpose: Even though early transplantation is still the first-line therapy in paediatric patients with end-stage renal disease (ESRD), up to 30% of these patients still require haemodialysis (HD). Creating an arteriovenous fistula (AVF) is quite challenging, particularly in children, leading to disproportional use of catheters. In this paper, we describe our experience in the creation of AVF with currently no in-dwelling catheters in children and adolescents on HD.

A modified approach of proximalization of arterial inflow technique for hand ischemia in patients with matured basilic and cephalic veins.

Objective: Proximalization of arteriovenous inflow (PAI) is an established technique for treating patients with access-induced hand ischemia. However, a prosthetic graft, used as arterial inflow, could minimize the benefits of a purely native fistula. In this study, a new PAI technique is reported, which avoids the use of prosthetic grafts in patients with matured basilic and cephalic veins.

Placing a primary arteriovenous fistula that works--more or less known aspects, new ideas.

Despite the pre-operative availability of well-defined criteria to create a primary arteriovenous fistula (AVF) a high early failure/missing maturation is complained worldwide. Based on new results from basic research using numerical techniques, the authors try to guide attention to a widely neglected field in published data: the unremarkable, small, but essential surgical details in creating a successful AVF. The aim is to describe their significance and to give them a place in a cross-border context.

Perforating vein fistula is superior to forearm fistula in elderly haemodialysis patients with diabetes and arterial hypertension.

Background: Access-related problems are one of the major causes of morbidity in elderly patients with chronic kidney disease. The aim of this study was to assess potential risks and benefits in elderly patients comparing forearm arteriovenous fistula (AVF) and perforating vein AVF below the elbow for primary vascular access.

Methods: A retrospective comparison of elderly patients (65.

Over-expression of IGF-related peptides in stenoses of native arteriovenous fistulas in hemodialysis patients.

Introduction: Insulin-like growth factors (IGFs) are known to play an important role in atherogenesis. The aim of our study was to assess the local expression of IGF-related peptides in stenosed hemodialysis fistulas and compare these with their respective serum levels.

Methods: We investigated 15 stenosed vein segments of primary arteriovenous fistulas, 29 non-stenosed control vein segments from uremic patients and 15 non-stenosed control saphenous vein segments.

History of vascular access for haemodialysis.

The history of vascular access is a history of vascular surgery as well as a history of dialysis therapy. This survey is a personal view on the history of vascular access without the ambition to cover every detail, but with an effort to mention the major steps in a fascinating panorama.

Should nephrologists be in charge?

Once, vascular access (VA) for hemodialysis treatment was initiated by nephrologists: Scribner introduced the arteriovenous shunt, Shaldon the central-venous catheters and Brescia-Cimino the arteriovenous fistula. Later on, creating VA became a domain of surgery. Many nephrologists felt out of responsibility.

Vascular access for dialysis in diabetic patients.

There is consent that arteriovenous fistulae as introduced by Brescia et al. (1) are the preferred choice in the field of vascular access for maintenance haemodialysis therapy. Worldwide, a rapidly growing population of older patients suffering from diabetes mellitus, mainly type 2, is observed.

The initial creation of native arteriovenous fistulas: surgical aspects and their impact on the practice of nephrology.

A highly welcomed, increasing number of arteriovenous fistulas (AVFs) has been noted in recent years as has a high rate of early failure. The latter is not an inevitable consequence of the former. Potential contributors may be identified by an analysis of surgical strategies and details of the creation of arteriovenous (AV) anastomoses.