Creation of secondary arteriovenous fistulas: Maximizing fistulas in prevalent hemodialysis patients

Arif Asif, Stephen W. Unger, Patricia Briones, Donna Merrill, Gautam Cherla, Oliver Lenz, David Roth, Phillip Pennell

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

National Kidney Foundation Dialysis Outcomes Quality Initiative (NKF-DOQI) guideline 29 suggests that a patient should be evaluated for a secondary arteriovenous fistula (AVF) following each episode of dialysis access failure. Regretfully, it does not appear that this approach is used, even though recent data have emphasized that veins suitable for the creation of a secondary AVF can be identified in dialysis patients who are receiving dialysis via a synthetic arteriovenous graft (AVG) or other type of potentially dysfunctional vascular access. In this study nine patients (five with an AVG and four with an AVF) with vascular access dysfunction undergoing percutaneous interventions were evaluated for secondary AVF creation. All were found to have suitable vascular anatomy and had the AVF created. The secondary fistula was successful in all nine patients with a mean follow-up of 4.8 ± 1.4 months in post-AVG cases and 5.6 ± 1.7 months in the post-AVF patients. In addition, it was possible to continue uninterrupted dialysis without the use of a tunneled dialysis catheter in three of the patients with AVGs. This experience demonstrates the validity and success of this approach to the management of dialysis access dysfunction. In the ongoing effort to optimize vascular health status, we suggest that during percutaneous interventions, patients should routinely have identification of vessels suitable for creation of a secondary AVF.

Original languageEnglish
Pages (from-to)420-424
Number of pages5
JournalSeminars in Dialysis
Volume18
Issue number5
DOIs
StatePublished - Sep 1 2005

Fingerprint

Arteriovenous Fistula
Fistula
Renal Dialysis
Dialysis
Blood Vessels
Transplants
Health Status
Veins
Anatomy
Catheters
Guidelines
Kidney

ASJC Scopus subject areas

  • Nephrology

Cite this

Creation of secondary arteriovenous fistulas : Maximizing fistulas in prevalent hemodialysis patients. / Asif, Arif; Unger, Stephen W.; Briones, Patricia; Merrill, Donna; Cherla, Gautam; Lenz, Oliver; Roth, David; Pennell, Phillip.

In: Seminars in Dialysis, Vol. 18, No. 5, 01.09.2005, p. 420-424.

Research output: Contribution to journalArticle

Asif, Arif ; Unger, Stephen W. ; Briones, Patricia ; Merrill, Donna ; Cherla, Gautam ; Lenz, Oliver ; Roth, David ; Pennell, Phillip. / Creation of secondary arteriovenous fistulas : Maximizing fistulas in prevalent hemodialysis patients. In: Seminars in Dialysis. 2005 ; Vol. 18, No. 5. pp. 420-424.
@article{4939cdac9b1546e6bd44b1b1e4260736,
title = "Creation of secondary arteriovenous fistulas: Maximizing fistulas in prevalent hemodialysis patients",
abstract = "National Kidney Foundation Dialysis Outcomes Quality Initiative (NKF-DOQI) guideline 29 suggests that a patient should be evaluated for a secondary arteriovenous fistula (AVF) following each episode of dialysis access failure. Regretfully, it does not appear that this approach is used, even though recent data have emphasized that veins suitable for the creation of a secondary AVF can be identified in dialysis patients who are receiving dialysis via a synthetic arteriovenous graft (AVG) or other type of potentially dysfunctional vascular access. In this study nine patients (five with an AVG and four with an AVF) with vascular access dysfunction undergoing percutaneous interventions were evaluated for secondary AVF creation. All were found to have suitable vascular anatomy and had the AVF created. The secondary fistula was successful in all nine patients with a mean follow-up of 4.8 ± 1.4 months in post-AVG cases and 5.6 ± 1.7 months in the post-AVF patients. In addition, it was possible to continue uninterrupted dialysis without the use of a tunneled dialysis catheter in three of the patients with AVGs. This experience demonstrates the validity and success of this approach to the management of dialysis access dysfunction. In the ongoing effort to optimize vascular health status, we suggest that during percutaneous interventions, patients should routinely have identification of vessels suitable for creation of a secondary AVF.",
author = "Arif Asif and Unger, {Stephen W.} and Patricia Briones and Donna Merrill and Gautam Cherla and Oliver Lenz and David Roth and Phillip Pennell",
year = "2005",
month = "9",
day = "1",
doi = "10.1111/j.1525-139X.2005.00080.x",
language = "English",
volume = "18",
pages = "420--424",
journal = "Seminars in Dialysis",
issn = "0894-0959",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Creation of secondary arteriovenous fistulas

T2 - Maximizing fistulas in prevalent hemodialysis patients

AU - Asif, Arif

AU - Unger, Stephen W.

AU - Briones, Patricia

AU - Merrill, Donna

AU - Cherla, Gautam

AU - Lenz, Oliver

AU - Roth, David

AU - Pennell, Phillip

PY - 2005/9/1

Y1 - 2005/9/1

N2 - National Kidney Foundation Dialysis Outcomes Quality Initiative (NKF-DOQI) guideline 29 suggests that a patient should be evaluated for a secondary arteriovenous fistula (AVF) following each episode of dialysis access failure. Regretfully, it does not appear that this approach is used, even though recent data have emphasized that veins suitable for the creation of a secondary AVF can be identified in dialysis patients who are receiving dialysis via a synthetic arteriovenous graft (AVG) or other type of potentially dysfunctional vascular access. In this study nine patients (five with an AVG and four with an AVF) with vascular access dysfunction undergoing percutaneous interventions were evaluated for secondary AVF creation. All were found to have suitable vascular anatomy and had the AVF created. The secondary fistula was successful in all nine patients with a mean follow-up of 4.8 ± 1.4 months in post-AVG cases and 5.6 ± 1.7 months in the post-AVF patients. In addition, it was possible to continue uninterrupted dialysis without the use of a tunneled dialysis catheter in three of the patients with AVGs. This experience demonstrates the validity and success of this approach to the management of dialysis access dysfunction. In the ongoing effort to optimize vascular health status, we suggest that during percutaneous interventions, patients should routinely have identification of vessels suitable for creation of a secondary AVF.

AB - National Kidney Foundation Dialysis Outcomes Quality Initiative (NKF-DOQI) guideline 29 suggests that a patient should be evaluated for a secondary arteriovenous fistula (AVF) following each episode of dialysis access failure. Regretfully, it does not appear that this approach is used, even though recent data have emphasized that veins suitable for the creation of a secondary AVF can be identified in dialysis patients who are receiving dialysis via a synthetic arteriovenous graft (AVG) or other type of potentially dysfunctional vascular access. In this study nine patients (five with an AVG and four with an AVF) with vascular access dysfunction undergoing percutaneous interventions were evaluated for secondary AVF creation. All were found to have suitable vascular anatomy and had the AVF created. The secondary fistula was successful in all nine patients with a mean follow-up of 4.8 ± 1.4 months in post-AVG cases and 5.6 ± 1.7 months in the post-AVF patients. In addition, it was possible to continue uninterrupted dialysis without the use of a tunneled dialysis catheter in three of the patients with AVGs. This experience demonstrates the validity and success of this approach to the management of dialysis access dysfunction. In the ongoing effort to optimize vascular health status, we suggest that during percutaneous interventions, patients should routinely have identification of vessels suitable for creation of a secondary AVF.

UR - http://www.scopus.com/inward/record.url?scp=27544483145&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=27544483145&partnerID=8YFLogxK

U2 - 10.1111/j.1525-139X.2005.00080.x

DO - 10.1111/j.1525-139X.2005.00080.x

M3 - Article

C2 - 16191183

AN - SCOPUS:27544483145

VL - 18

SP - 420

EP - 424

JO - Seminars in Dialysis

JF - Seminars in Dialysis

SN - 0894-0959

IS - 5

ER -