Safety and efficacy of an innovative external support device for de novo arterio-venous fistula creation: a French bicentric experience.

Background: The aim of this study was to evaluate the safety and efficacy of VasQ, a permanent extravascular nitinol vascular support device, implanted around the anastomosis of de novo arteriovenous fistulas (AVF), in consecutive patients.

Methods: This was a French prospective bicentric study. All patients with an indication for creation of a distal or proximal end to side AVF performed by supervised trainee were eligible.

Establishing an autogenous vascular access program in a Guatemalan comprehensive pediatric nephrology center.

Background: The Guatemalan Foundation for Children with Kidney Diseases collaborated with Bridge of Life, a not-for-profit charitable organization, to establish a vascular access program. We reviewed our experience with graded surgical responsibility and structured didactic training, creating arteriovenous fistulas (AVF) for Guatemalan children.

Methods: Pediatric vascular access missions were completed from 2015 to 2023 and analyzed retrospectively.

Endovascular Arteriovenous Fistula Creation-Review of Current Experience.

Functioning vascular access is an essential element for life-saving hemodialysis therapy. A surgically-created arteriovenous fistula has been considered the best option for many years. Recently, two manufacturers developed systems for percutaneous/endovascular creation of an arteriovenous fistula (WavelinQ and Ellipsys).

Customizable modification of banding with external stenting for arteriovenous fistula flow reduction.

We performed a single-center retrospective study of prospectively collected data for all patients who had flow reduction surgery with FRAME FR between November 2020 and January 2021. Ten patients had arteriovenous fistula flow reduction surgery with this technique. One patient had a distal fistula, whereas nine were within the cubital fossa.

Use of chronically occluded fistula to establish access outflow.

Maintaining a good quality vascular access in the long term can become particularly challenging especially in patients that are on dialysis for many years and present with exhausted venous capital and chronic access related complications. We present a 60-year-old female patient with multiple bilateral previous failed accesses, a previous distal revascularization interval ligation (DRIL) for hemodialysis access induced distal ischemia (HAIDI). Her chronically (more than a month) occluded arteriovenous fistula AVF was used to establish outflow and create a functioning forearm arteriovenous graft (AVG).

Percutaneous arteriovenous fistula creation.

The first percutaneous systems used to create an arteriovenous fistula for hemodialysis were approved by the US Food and Drug Administration in 2018 and included the Ellipsys and WavelinQ devices. Early results and longer-term studies of these catheter-based devices suggest that they offer important benefits and potentially improved outcomes in patients with appropriate anatomy. The deep communicating vein in the cubital fossa and its relationship to the proximal radial artery or proximal ulnar artery are key vascular elements of both systems.

Creating reverse flow arteriovenous fistulas with a forearm cannulation target.

Background: Establishing a forearm arteriovenous fistula (AVF) offers preferred cannulation sites and preserves proximal access opportunities. When a radiocephalic AVF at the wrist is not feasible and the upper arm cephalic and median cubital veins are inadequate, an AV graft or more complex access procedure is often required. Creating a retrograde flow forearm AVF (RF-AVF) is a valuable alternative where the mid-forearm median antebrachial or cephalic vein is adequate, offering forearm cannulation zones with AVF outflow through deep and superficial collaterals.

Paclitaxel-Coated Balloons for the Treatment of Symptomatic Central Venous Stenosis in Vascular Access: Results From a European, Multicenter, Single-Arm Retrospective Analysis.

Introduction: This was a European, multicenter, investigator-initiated and run, single-arm retrospective analysis to assess the safety and the clinical benefit of the use of paclitaxel-coated balloon (PCB) for the treatment of symptomatic central venous stenosis (CVS).

Materials And Methods: Eleven centers from 7 countries across Europe, submitted 86 cases performed during the period between October 2015 and June 2018. Minimum follow-up was 6 months.

Comparison of surgical versus percutaneously created arteriovenous hemodialysis fistulas.

Objective: The aim of the present study was to compare the results between percutaneous arteriovenous fistulas (p-AVFs) created with the Ellipsys device (Ellipsys Vascular Access System; Avenu Medical, San Juan Capistrano, Calif) and surgical arteriovenous fistulas (s-AVFs).

Methods: A single-center retrospective comparative study of the first 107 patients who had undergone p-AVF creation with the Ellipsys system from May 2017 to May 2018 with an equal number of consecutive patients who had undergone s-AVF creation in our center during the same period. The primary endpoints included the maturation and patency rates.

The challenge of stent placement within cannulation zones of Arteriovenous Fistulae.

Background: Stent placement in the cannulation zone of AVF is becoming alarmingly frequent and sometimes in cases where surgical management would be more appropriate. When complications arise repair can be particularly challenging. We present our experience and management of this problem.

Avoiding hemodialysis access-induced distal ischemia.

Timely creation and maintenance of a safe and reliable vascular access is essential for hemodialysis patients with end-stage renal disease. Hemodialysis access-induced distal ischemia (HAIDI) is a recognized complication of arteriovenous fistulas and grafts that may result in serious or even devastating consequences. Avoiding such complications is clearly preferred over treatment of HAIDI once established.

Percutaneous creation of proximal radio-radial arteriovenous hemodialysis fistula before secondary brachial vein elevation.

Objective: We evaluate the creation of a percutaneous proximal radial artery-radial vein arteriovenous fistula with Ellipsys instead of the usual first-stage brachial artery fistula prior to a second-stage brachial vein elevation, in patients with inadequate cephalic and basilic veins.

Methods: Single center study of eight patients (six males, mean = 54 years) who underwent a two-stage brachial vein elevation procedure between May 2017 and October 2019. Inclusion criteria were life expectancy > 6 months, patent brachial and proximal radial artery (>2 mm in diameter) absent/inadequate cephalic and basilic veins, existence of a brachial vein >3 mm in diameter, and in continuity with a proximal radial vein > 2 mm in diameter.

Creating percutaneous radiocephalic arteriovenous fistulas at the wrist.

Background: The first arteriovenous fistulas were created at the wrist more than 60 years ago. Basic surgical construction techniques remain unchanged with mobilization and repositioning of the vessels followed by a sutured anastomosis. We used the Ellipsys device to construct percutaneous radiocephalic-arteriovenous fistulas at the wrist and report the results.

Iatrogenic jugulo-subclavian fistula.

Iatrogenic arteriovenous fistula of major neck vessels is a rare complication but can occur after central venous catheterization. Symptoms can range from nothing to severe heart failure and management can be particularly complex. We report a case that we treated recently in our department.