Advertisement

A Review of the Current Status of Percutaneous Endovascular Arteriovenous Fistula Creation for Haemodialysis Access

  • Robert G. JonesEmail author
  • Robert A. Morgan
Review

Abstract

Surgical fistulas were first described over 50 years ago and have revolutionized the outlook for millions of dialysis-dependent patients. Despite many developments, results remain sub-optimal with high rates of primary failure and re-intervention to maintain patency. Surgical fistulas are known to fail in part due to intimal hyperplasia leading to stenosis, and vessel manipulation during anastomosis creation can be contributory. New technology is emerging that allows the endovascular creation of fistulas with minimal vessel trauma and the initial results demonstrate encouraging outcomes with high technical success rates, low re-intervention, and failure rates and good usability for hemodialysis. Two such device systems are currently available, and here, we provide an overview of the current global status of endoAVF, patient selection criteria, trial results, technical aspects, re-interventions, and outlook for the future.

Keywords

Endovascular Dialysis fistulas Renal failure Interventional radiology AVF creation 

Notes

Compliance with Ethical Standards

Conflict of interest

Robert G Jones: Speaker/Consultancy for TVA. Robert A Morgan: Speaker for TVA, Penumbra, and Medtronic.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article: Does not apply.

References

  1. 1.
    Peterson W, et al. Disparities in fistula maturation persist despite preoperative vascular mapping. Clin J Am Soc Nephrol. 2008;3(2):437–41.CrossRefGoogle Scholar
  2. 2.
    Lee T, et al. Tunneled catheters in hemodialysis patients: reasons and subsequent outcomes. Am J Kidney Dis. 2005;46(3):501–8.CrossRefGoogle Scholar
  3. 3.
    Biuckians A, Scott EC, Meier GH, et al. The natural history of autologous fistulas as first-time dialysis access in the KDOQI era. J Vasc Surg. 2008;47:415–21.CrossRefGoogle Scholar
  4. 4.
    Dember LM, Beck GJ, Allon M, et al. Effect of clopidogrel on early failure of arteriovenous fistulas for hemodialysis: a randomized controlled trial. JAMA. 2008;299:2164–71.CrossRefGoogle Scholar
  5. 5.
    Kimball, et al. Efficiency of the kidney disease outcomes quality initiative guidelines for preemptive vascular access in an academic setting. J Vasc Surg. 2011;54(3):760–6.CrossRefGoogle Scholar
  6. 6.
    Falk AM. Maintenance and salvage of arteriovenous fistulas. J Vasc Interv Radiol. 2006;17:807–13.CrossRefGoogle Scholar
  7. 7.
    Stolic R. Most important chronic complications of arteriovenous fistulas for hemodialysis. Med Princ Pract. 2012;22:220–8.CrossRefGoogle Scholar
  8. 8.
    Dhingra RK, Young EW, Hulbert-Shearon TE, et al. Type of vascular access and mortality in U.S hemodialysis patients. Kidney Int. 2001;60:1443–51.CrossRefGoogle Scholar
  9. 9.
    Roy-Chaudhury P, Sukhatme VP, et al. Hemodialysis vascular access dysfunction: a cellular and molecular viewpoint. J Am Soc Nephrol. 2006;17:1112–27.CrossRefGoogle Scholar
  10. 10.
    Rajan DK, Ebner A, Desai SB, et al. Percutaneous creation of an arteriovenous fistula for hemodialysis access. J Vasc Interv Radiol. 2015;26:484–90.CrossRefGoogle Scholar
  11. 11.
    Hull JE, Elizondo-Riojas G, Bishop W, et al. Thermal resistance anastomosis device for the percutaneous creation of arteriovenous fistulae for hemodialysis. J Vasc Interv Radiol. 2017;28:380–7.CrossRefGoogle Scholar
  12. 12.
    Lok CE, Rajan DK, Clement J, et al. Endovascular proximal forearm arteriovenous fistula for hemodialysis access: results of the prospective, multicentre novel endovascular access trial (NEAT). Am J Kidney Dis. 2017;70(4):486–97.CrossRefGoogle Scholar
  13. 13.
    Radosa CG, Radosa JC, Weiss N, et al. Endovascular creation of an arteriovenous fistula (endoAVF) for hemodialysis access: first results. Cardiovasc Interv Radiol. 2017;40(10):1545–51.CrossRefGoogle Scholar
  14. 14.
    Hull JE, Jennings WC, Cooper RI, et al. The pivotal multicentre trial of ultrasound-guided percutaneous arteriovenous fistula creation for hemodialysis access. J Vasc Interv Radiol. 2018;29:149–58 (EPUB).CrossRefGoogle Scholar
  15. 15.
    Mallios A, Jennings WC, Boura B et al. Early results of percutaneous arteriovenous fistula creation with the Ellipsys Vascular Access System. J Vasc Surg. 2018.  https://doi.org/10.1016/j.jvs.2018.01.036.CrossRefPubMedGoogle Scholar
  16. 16.
    Hull JE, KinseyEN BishopWL. Mapping of the snuffbox and cubital vessels for percutaneous arterial venous fistula (pAVF) in dialysis patients. J Vasc Access. 2013;14:245–51.CrossRefGoogle Scholar
  17. 17.
    Gracz KC, Ing TS, Soung LS, et al. Proximal forearm fistula for maintenance hemodialysis. Kidney Int. 1977;11(1):71–5.CrossRefGoogle Scholar
  18. 18.
    Toledo-Pereyra LH, Kyriakides GK, Ma KW, Miller J. Proximal radial artery—cephalic vein fistula hemodialysis. Arch Surg. 1977;112:226–7.CrossRefGoogle Scholar
  19. 19.
    Al-Jaishi AA, Oliver MJ, Thomas SM, et al. Patency Rates of the Arteriovenous fistula for hemodialysis: a systematic review and meta-analysis. Am J Kidney Dis. 2014;63(3):464–78.CrossRefGoogle Scholar
  20. 20.
    Jennings WC. Creating arteriovenous fistulas in 132 consecutive patients: exploiting the proximal radial artery arteriovenous fistula: reliable, safe and simple forearm and upper arm hemodialysis access. Arch Surg. 2006;141:27–32.CrossRefGoogle Scholar
  21. 21.
    Yang S, Lok C, Arnold R, et al. Comparison of post-creation procedures and costs between surgical and an endovascular approach to arteriovenous fistula creation. J Vasc Access. 2017;18(suppl. 2):8–14.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  1. 1.Interventional Radiology DepartmentQueen Elizabeth Hospital BirminghamBirminghamUK
  2. 2.Interventional Radiology DepartmentSt Georges University of LondonLondonUK

Personalised recommendations