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Enfermería Nefrológica
On-line version ISSN 2255-3517Print version ISSN 2254-2884
Abstract
SANCHEZ-VILLAR, Isidro; GARCIA-GONZALEZ, Zoraida; PESTANA-RODRIGUEZ, Raquel and GARCIA-RUIZ, Ana. A percutaneous system for the creation of arteriovenous fistulas in hemodialysis patients: our initial experience. Enferm Nefrol [online]. 2022, vol.25, n.3, pp.258-262. Epub Dec 05, 2022. ISSN 2255-3517. https://dx.doi.org/10.37551/52254-28842022026.
Introduction:
Arteriovenous fistula is considered the priority access for hemodialysis patients. In recent years, an alternative to the surgical creation of an arteriovenous fistula has been chosen, such as the endovascular arteriovenous fistula. This new technology involves a less aggressive and non-surgical approach.
Objective:
To describe the preliminary data from our unit after the implementation of this novel system, as well as the nurse involvement.
Material and Method:
Retrospective descriptive analysis of the endovascular AVFs performed in five patients using the percutaneous technique. The characteristics of the patients, the endovascular AVFs performed and the difficulty of puncture (VAS scale) were considered.
Results:
Mean age was 63(47-77) years, 100% male, dialysing with a tunneled catheter, 4 of the patients had at least one unsuccessful surgical arteriovenous fistula. Endovascular AVF creation was successful in 4 of the 5 patients, all with radio-radial location. There were no complications during the procedure. Of the 4 endovascular AVFs 3 required subsequent endovascular intervention for maturation. The median maturation time was 4.5 (4-5) months; all 4 remained permeable at 1 year.
The median difficulty score by 9 experienced nurses was for initial puncture: 7; after 1 month: 5 and compared to surgical AVFs: 5.
Conclusions:
Endovascular AVF was a minimally invasive procedure with lower patient impact, high initial success, but required subsequent endovascular intervention for maturation. Difficulty of puncture was higher initially. The absence of scar as a baseline meant a more thorough exploration.
Keywords : hemodialysis; arteriovenous fistula; vascular access; endovascular arteriovenous fistula; nursing; WavelinQ.