Abstract: FR-PO1075
Novel Intermittent Pneumatic Compression Device Promotes Early Cannulation
Session Information
- Late-Breaking Clinical Trial Posters
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 603 Hemodialysis: Vascular Access
Author
- Singh, Tej M., Palo Alto Medical Foundation, Los Altos Hills, California, United States
Background
Arteriovenous fistulas (AVF) are the preferred for hemodilaysis access.However, AVF maturation has been poor globally. Poor maturation often leads to increased catheter contact time and costs. Intermittent compression of upper arm veins may aid in forearm vein dilation. Early use of non-invasive devices may help in maturation and possible early AVF needle cannulation.
Methods
After AVF creation,an intermittent pneumatic compression device [Fist Assist® (FA)] was applied to allow cyclic compression of 60 mm Hg daily for 90 days. Fourty (n=40) AVF patients were in the study arm to test vein dilation with FA and needle cannulation time. Of these patients, twenty-four (n=24) had brachiocephalic fistulas (BCF), while seventeen (n=16) had radiocephalic fistulas (RCF). Controls (n=16) used a sham device. Vein size was measured and recorded at baseline and after 90 days by duplex measurement. Clinical results (percentage increase) were recorded and tested for significance. Time to fistula cannulation was recorded as the difference between surgery date and needle placement.
Results
After three months, the mean percentage increase in vein diameter in the FA treatment group with RCF was significantly larger than those with BCF at proximal locations of 5 cm, 10 cm, and 15 cm from the anastomosis (p=0.000, 0.000, and 0.017, respectively) compared to the control group. Fistulas treated with the FA device were cannulated sooner by 4 days in the clinic (Control: 43.8+8/7 days vs. FA: 39.2+9.6)[Table 1] . All fistulas treated with FA are still functional with no reported thrombosis or extravasations.
Conclusion
Improved AVF maturation is important for vascular access care and has been an important goal.Early application of an intermittent pneumatic compression may be successful in AVF maturation at longer time points as demonstrated in this comparative study. Pneumatic devices may assist in early cannulation of AVF.
MEAN FISTULA TIME
A significant decrease in mean fistula time was observed for the Treatment group vs. Control group
Funding
- Private Foundation Support