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Kidney Week

Abstract: PO1041

Feasibility of Creation of an Endovascular Arteriovenous Fistula in Patients Undergoing Preoperative Vascular Mapping

Session Information

Category: Dialysis

  • 703 Dialysis: Vascular Access

Authors

  • Albalas, Alian, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Madi, Salam, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Almehmi, Ammar, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Robbin, Michelle L., The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Allon, Michael, The University of Alabama at Birmingham, Birmingham, Alabama, United States
Background

The endovascular arteriovenous fistula (endoAVF), a novel percutaneous technique of AVF creation, was approved by the Food and Drug Administration in 2018, and has been placed in a small number of U.S. hemodialysis patients. It is unknown how often patients with advanced chronic kidney disease have vascular anatomy suitable for endoAVF creation. The goal of the present study was to determine the proportion of patients with a vascular anatomy suitable for endoAVF creation, and to assess patient characteristics associated with such suitability.

Methods

All patients referred for vascular access placement at a large academic medical center underwent standardized preoperative sonographic vascular mapping to assess suitability for an AVF. During a two-year period (March 2019 to March 2021), we assessed the suitability of the vessels for creation of an endoAVF. We then compared the demographic characteristics, comorbidities, and vascular mapping measurements between patients who were or were not suitable for an endoAVF.

Results

During the study period, 223 patients had preoperative vascular mapping results suitable for creation of a surgical AVF. Of these, 140 patients (63%) were also suitable for an endoAVF. Patients with a vascular anatomy suitable for an endoAVF were younger (age 55±15 vs 60±14 years, p=0.01), but similar in sex, race, diabetes, hypertension, coronary artery disease, and peripheral artery disease.

Conclusion

Among patients with chronic kidney disease with vascular anatomy suitable for a surgical AVF, 63% are also suitable for an endoAVF. Older patients are less frequently suitable for an endoAVF.

Funding

  • NIDDK Support