Abstract: SA-PO0448
Optimizing Patient Selection and Performance of Endovascular Arteriovenous Fistula Creation Using the WavelinQ EndoAVF System: It's Not the Perforator
Session Information
- Dialysis: Vascular Access
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Kurbanov, Alexander, Kidney Care and Transplant Services of New England PC, West Springfield, Massachusetts, United States
- Landry, Daniel L., Kidney Care and Transplant Services of New England PC, West Springfield, Massachusetts, United States
- Madden, Robert L., Kidney Care and Transplant Services of New England PC, West Springfield, Massachusetts, United States
- Braden, Gregory Lee, Kidney Care and Transplant Services of New England PC, West Springfield, Massachusetts, United States
- Mulhern, Jeffrey, Kidney Care and Transplant Services of New England PC, West Springfield, Massachusetts, United States
Background
Percutaneous arteriovenous fistula creation is an underutilized method of establishing access in advanced CKD and dialysis patients as studies report superior outcomes compared to surgically created fistulas. As WavelinQ remains the only FDA approved device, we created a dedicated multidisciplinary team to introduce the WavelinQ procedure to our center starting in 2025.
Methods
Protocol driven initial and subsequent Doppler ultrasound testing was performed by a dedicated surgeon to evaluate and follow candidates for percutaneous creation. Initial Doppler ultrasound findings were confirmed after successful supraclavicular brachial plexus block.
Results
Twenty-five percutaneous common ulnar artery to ulnar vein arteriovenous fistulas have been created accounting for 60% of all current year fistulas. Most procedures included brachial vein coil embolization. Two cases were not performed due to inability to access fistula creation zone. No major complications were identified.
Conclusion
Timing of permanent access placement in the CKD population is complicated. Limiting catheter exposure in the dialysis patient is essential. Our preliminary data endorses preferential targeting of the lateral ulnar vein during the WavelinQ procedure. Accessing the lateral ulnar vein led to greater early proximal cephalic vein enlargement, adequate proximal cephalic vein size (> 5mm), and suitable brachial artery flow (> 500 ml/m) when compared to the medial ulnar vein approach. Importantly, these findings were independent of perforator size and all developed within 2 weeks of creation. Deploying the WavelinQ device in the lateral ulnar vein location may allow for more rapid establishment of a functioning access, lessen catheter days, and deserves further exploration.
| Percutaneous Approach | Medial Ulnar Vein | Lateral Ulnar Vein | |
| Initial screen | |||
| Proximal Cephalic Vein size (mm) | 4.9(0.67) | 4.6(0.37) | ns |
| Perforator size (mm) | 3.75(0.25) | 3.42(0.2) | ns |
| Post creation follow up (2 weeks) | |||
| Brachial Artery Flow (BAF) (ml/m) | 618(116) | 870(262) | ns |
| BAF > 500 ml/m (%) | 60 | 87 | ns |
| Proximal Cephalic Vein size change (mm) | 1.1(0.26) | 2.6(0.25) | <0.01 |
| Proximal Cephalic Vein size > 5 mm (%) | 60 | 100 | ns |