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Abstract: SA-OR025

Robotic Artificial Intelligence (AI)-Guided Tomographic Ultrasonography: Breakthrough in Haemodialysis Access Planning

Session Information

Category: Dialysis

  • 803 Dialysis: Vascular Access

Authors

  • Broumand, Varshasb, South Texas Renal Care Group, San Antonio, Texas, United States
  • Thomas, Shannon Dean, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia
  • Block, Geoff, US Renal Care Inc, Decatur, Georgia, United States
  • Mizani, Mohammad R., South Texas Renal Care Group, San Antonio, Texas, United States
  • Colley, Eamonn, Vexev, Sydney, New South Wales, Australia
  • Carroll, John, Vexev, Sydney, New South Wales, Australia
Background

Ultrasound mapping improves vascular access (VA) outcomes in end-stage renal disease (ESRD), but timely access is often limited. The VxWave Ultrasound Imaging System is a novel semi-autonomous robotic tomographic ultrasound (RTU) device designed to deliver high-quality vascular scans and reports.

Methods

A multicenter, prospective observational study (CANSCAN) evaluated the feasibility of dialysis staff performing RTU scans on ESRD patients using the VxWave System, and whether scan data yielded sufficient information to inform VA strategies. Staff at 3 centers were trained to position patient's arms in the VxWave System. Patients with CKD 4/5 and no prior upper limb access were enrolled. Primary endpoints: (1) scan success rate, (2) scans sufficient for access planning (per 3 VA specialists), and (3) access eligibility. Secondary endpoints: presence of venous trunks (>2 mm), mean vessel diameters, time to report, staff compliance, and user satisfaction scores.

Results

Of 115 patients, 109 (95%) had successful scans, all rated adequate by ≥2 vascular access specialists. Forearm AVF was suitable in 24% (100% radiocephalic), upper arm AVF in 90% (86% brachiobasilic, 62% brachiocephalic), Gracz/percutaneous AVF in 61%, AVG in 98%, and no viable option in 14%. Mean scan time was ~21 minutes/arm (SD 1min 42s). Staff reported high workflow feasibility and integration. No serious adverse events or unexpected device effects occurred.

Conclusion

VxWave-enabled semi-autonomous vascular scans by non-imaging trained dialysis staff are feasible, efficient, and yield actionable data. Future studies will assess diagnostic accuracy, long-term access outcomes, and broader use in diverse dialysis settings.

Arterial and Venous Anatomy
SegmentN, MD, SD, %>2mm
Forearm Veins 
● Cephalic Vein
● Median Antecubital Extension Vein
● Basilic Vein
56,2.6mm±0.9mm,17%
86,3.3mm±1.0mm,52%
83,3.0mm ±0.9mm,33%
Antecubital Veins 
● Perforating Vein
● Median Antecubital Cephalic Vein
● Median Antecubital Basilic Vein
98,3.4mm±0.9mm,90%
88,4.3mm±1.0mm,82%
96,4.0mm ±0.6mm,84%
Upper Arm Veins 
● Cephalic Vein
● Basilic Vein
● Brachial Vein
85,3.5mm±1.2mm,60%
99,4.8mm ±1.4mm,78%
104,2.4mm ±1.1mm,89%
Brachial Artery
NB: 5 patients with high bifurcation at axilla excluded
104,5.4mm±1.4mm
Radial Artery109,3.1mm±0.8mm
Ulnar Artery109,3.4mm ±0.9mm

Number of subjects measured(N),mean diameter(MD),standard deviation(SD),% of veins >2mm across all segments

Funding

  • Commercial Support – Vexev Pty Ltd

Digital Object Identifier (DOI)