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Abstract: TH-PO268

The Initial Experience of Endovascular Arteriovenous Fistula Creation in a Multi-Ethnic Population From Singapore

Session Information

Category: Dialysis

  • 703 Dialysis: Vascular Access

Authors

  • Tan, Ru Yu, Singapore General Hospital, Singapore, Singapore
  • Tay, Hsien Ts'ung, Singapore General Hospital, Singapore, Singapore
  • Zhuang, Kun Da, Singapore General Hospital, Singapore, Singapore
  • Pang, Suh Chien, Singapore General Hospital, Singapore, Singapore
  • Alvin, Tng Ren kwang, Singapore General Hospital, Singapore, Singapore
  • Tan, Chee Wooi, Singapore General Hospital, Singapore, Singapore
  • Gan, Chye Chung, Singapore General Hospital, Singapore, Singapore
  • Phang, Chee Chin, Singapore General Hospital, Singapore, Singapore
  • Tay, Kiang Hiong, Singapore General Hospital, Singapore, Singapore
  • Chong, Tze tec, Singapore General Hospital, Singapore, Singapore
  • Tan, Chieh-suai, Singapore General Hospital, Singapore, Singapore
Background

The technique of endovascular arteriovenous fistula (EndoAVF) creation was made available in Singapore end of 2021. This study reports the initial experience of EndoAVF creation in a tertiary center in Singapore.

Methods

The patients referred for creation of new AVF was offered EndoAVF. Enrolled patient had vein mapping performed according to protocol and underwent EndoAVF creation if suitable. Data was collected prospectively for patients who underwent EndoAVF creation.

Results

A total of 15 patients were enrolled and underwent vein mapping. Of which, 11 patients were deemed suitable for EndoAVF creation and underwent the procedure under regional anesthesia. The patients have a mean age of 60 ± 10 years and were predominantly male (64%) and of Chinese (91%) ethnicity. The etiology of end-stage renal disease was diabetes mellitus (55%) followed by chronic glomerulonephritis (36.4%) and others (9%). Seven patients (64.6%) were already on hemodialysis via tunneled dialysis catheter while the remaining 4 patients were pre-emptive creation. EndoAVFs were successfully created in 10 (91%) patients. The anastomoses were radial-radial (50%) and ulnar-ulnar (50%). The brachial artery blood flow immediately, at 1- and 2-month post-creation was 544 ± 191, 612 ± 217, and 830 ± 401 mls/min, respectively. At 3-month, post-creation, 9 EndoAVF was assessed to be matured on clinical examination with a median maturation time of 70 (45, 95) days. Eight patients had successful 2-needle cannulation at a median time of 75 (52,128) days. Two patients required endovascular intervention to assist in maturation.

Conclusion

EndoAVF creation seemed feasible in the Asian population and may represent an attractive alternative to open surgery. Long-term data regarding its patency and cost-effectiveness needs to be evaluated in future studies

Funding

  • Private Foundation Support