AI Article Synopsis

  • Recent advancements in devices for creating endovascular arteriovenous fistulas have emerged, leading to a comparison of these methods with traditional surgical techniques.
  • A study analyzed data over three years, finding that endovascular WavelinQ fistulas had higher procedural success and better primary patency rates at 6 and 12 months compared to surgical radiocephalic fistulas.
  • The superior outcomes of WavelinQ suggest it could be a preferred initial option for creating fistulas, especially when wrist vessels are inadequate.

Article Abstract

Purpose: Devices to permit percutaneous endovascular arteriovenous fistula formation have recently been introduced into clinical practice with promising initial evidence. As guidelines support a distal fistula first policy, the question of whether an endovascular arteriovenous fistula should be performed as an initial option is introduced. The aims of this study were to compare a matched cohort of endovascular arteriovenous fistula with surgical radiocephalic arteriovenous fistulas.

Materials And Methods: Using data from a prospectively collected database over a 3-year period, a matched comparative analysis was performed.

Results: WavelinQ arteriovenous fistulas (group W,  = 30) were compared with radiocephalic arteriovenous fistulas (group RC;  = 40). Procedural success was high with 96.7% for group W and 92.6% for group RC. Primary patency at 6 and 12 months was greater in group W (65.5% 6mo and 56.5% 12mo) compared to group RC (53.4% 6mo and 44% 12mo) ( = 0.69 and 0.63). Mean primary patency was significantly lower for RC (235 ± 210 days) vs W (362 ± 240 days) ( < 0.05). Secondary patency for group W was 75.8% and 69.5% at 6 and 12 months, respectively. Secondary patency for RC was lower at 66.7% and 57.6% at 6 and 12 months, respectively.

Conclusion: Outcomes of WavelinQ arteriovenous fistulas in this series are similar to published results. When compared to a contemporaneously created group of surgical fistulas, WavelinQ demonstrated superior outcomes. These data would support that WavelinQ endovascular arteriovenous fistulas may be considered as a first option in the access pathway particularly if vessels at the wrist are absent or less than ideal.

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Source
http://dx.doi.org/10.1177/1129729819897168DOI Listing

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