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간행물 검색
Patency Rates of Arteriovenous Fistula Created Endovascularly in Singapore
Shi Yun Tan
2024 ; 2024(1):
논문분류 :
춘계학술대회 초록집
Objectives: Endovascular arteriovenous fistula (EndoAVF) creation is a minimally invasive technique which has surfaced as an alternative to open surgery and was first performed in Singapore in 2021. We aim to report the patency rates of EndoAVF that were created in Singapore. Methods: Patients eligible for EndoAVF based on vein mapping criteria were offered the option of EndoAVF. All patients who were recruited provided informed consent before undergoing EndoAVF creation. These patients were followed up prospectively for at least 6 months, and their baseline demographics, maturation rates, cannulation characteristics and patency rates were studied. Results: EndoAVF creation was attempted in 37 patients (19 WavelinQ and 17 Ellipsys) between October 2021 to July 2023. Of which, 33 cases (89.2%) were successful. The success rate for WavelinQ and Ellipsys systems were 89.5% and 88.9%, respectively. The median age of the patients was 62 (35-78) and they were predominantly of Chinese (78%) ethnicity. In terms of etiology of kidney disease, diabetes mellitus was most common (59%) followed by chronic glomerulonephritis (29%). 10 patients (27%) underwent pre-emptive creation. 90.0% of the EndoAVFs were successfully matured and 84.8% had successful 2-needle cannulation for haemodialysis. Two EndoAVFs were abandoned for failed balloon assisted maturation and recurrent thrombosis. The median maturation time was 45 days (26-218). At 6 months, 2 of 33 patients with successfully created EndoAVFs had passed on. The primary, assisted primary and secondary patency rates of EndoAVF were 51.6%, 87% and 93.5%, respectively. Conclusions: EndoAVF creation in an Asian population appears feasible with good functional patency outcomes at 6 months. This may represent a viable alternative to open surgery in suitable patients. Longer term analysis of patency and intervention rates in a larger population will need to be evaluated in future studies.
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