Endovascular Creation of Haemodialysis Arteriovenous Fistula

Abstract

Surgical fistulas have been used to create dialysis access for over 50 years in chronic kidney disease patients. However, due to problems like slow maturation and a high risk of thrombosis or stenosis, results remain sub-optimal with high intervention and surgery rates to maintain patency. Endovascular methods for fistula creation were invented recently to resolve these issues, allowing haemodialysis patients to have an alternative non-surgical option, with two different devices currently available. Endovascular creation of A-V fistulas is involved with minimal vessel trauma, which could be the reason for encouraging initial results demonstrating high technical success rates, low intervention rates, and good patient satisfaction. This article describes the technical aspects of these procedures, patient selection as well as trial results, and the status of endovascular arteriovenous fistula creation.

Keywords

• Chronic kidney disease
• Dialysis access
• Arteriovenous fistula
• Surgery
• Endovascular procedures