High rate of fistula use, low rates of secondary procedures and complications seen at five years
TUESDAY, Nov. 16, 2021 (HealthDay News) — A percutaneous arteriovenous fistula (pAVF) created by an interventionalist in the office-based lab provides durable access for hemodialysis through five years, according to a study presented at Kidney Week, the annual meeting of the American Society of Nephrology, held virtually from Nov. 4 to 7.
Jeffrey E. Hull, M.D., from Richmond Vascular Center in Virginia, and colleagues evaluated long-term outcomes (median follow-up of 50 months) of a two-stage procedure with creation followed by maturation of proximal radial artery fistula for hemodialysis to assess durability and complications.
The researchers found that pAVF was successfully used in 83 of 90 patients undergoing hemodialysis. Nonuse of pAVF occurred in 24 of 107 patients, owing to five cases of pAVF not created, five abandoned, eight deaths, one transplant, one predialysis, two lost to follow-up, one catheter, and one peritoneal dialysis. During five years, 0.93 procedures performed per patient per year (PPPY) were needed to maintain function and patency, with 2.63 in the first year, followed by declines to 0.25, 0.57, 0.18, and 0.24 in years 2 to 5, respectively. Secondary patency in years 1 to 5 was 89.5, 88.4, 88.4, 85.6, and 82.0 percent, respectively. For years 1 to 4, functional patency was 97.5, 97.5, 97.5, and 91.8 percent, respectively, after two-needle cannulation.
“The data demonstrate safety, effectiveness, and durability of the Ellipsys fistula as an alternative to surgery for patients needing dialysis,” Hull said in a statement. “In ongoing studies, the costs and clinical benefits of the Ellipsys fistula are being further evaluated.”
The authors disclosed commercial support for the study.
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