https://doi.org/10.1177/1129729819889793
The Journal of Vascular Access
1–8
© The Author(s) 2019
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DOI: 10.1177/1129729819889793
journals.sagepub.com/home/jva
JVA
Te Journal of
Vascular Access
Patient selection, education, and
cannulation of percutaneous arteriovenous
fistulae: An ASDIN White Paper
Haimanot Wasse
1
, Alejandro C Alvarez
2
,
Debbie Brouwer-Maier
3
, Jeffrey E Hull
4
,
Saravanan Balamuthusamy
5
, Terry F Litchfield
6
,
Randy I Cooper
7
, Dheeraj K Rajan
8
, Vandana Dua Niyyar
9
,
Anil K Agarwal
10
, Kenneth Abreo
11
, Charmaine E Lok
12
and William C Jennings
13
Abstract
End-stage kidney disease patients who are candidates for surgical arteriovenous fistula creation commonly experience
obstacles to a functional surgical arteriovenous fistula, including protracted wait time for creation, poor maturation,
and surgical arteriovenous fistula dysfunction that can result in significant patient morbidity. The recent approval of two
endovascular devices designed to create a percutaneous arteriovenous fistula enables arteriovenous fistula creation to be
placed in the hands of interventionalists, thereby increasing the number of arteriovenous fistula providers, reducing wait
times, and allowing the patient to avoid surgery. Moreover, current studies demonstrate that patients with percutaneous
arteriovenous fistula experience improved time to arteriovenous fistula maturation. Yet, in order to realize the potential
advantages of percutaneous arteriovenous fistula creation within our hemodialysis patient population, it is critical to
select appropriate patients, ensure adequate patient and dialysis unit education, and provide sufficient instruction in
percutaneous arteriovenous fistula cannulation and monitoring. In this White Paper by the American Society of Diagnostic
and Interventional Nephrology, experts in interventional nephrology, surgery, and interventional radiology convened
and provide recommendations on the aforementioned elements that are fundamental to a functional percutaneous
arteriovenous fistula.
Keywords
Percutaneous arteriovenous fistula, endovascular arteriovenous fistula, dialysis access, patient selection, cannulation,
dialysis education
Date received: 21 September 2019; accepted: 6 October 2019
1
Department of Internal Medicine and Division of Nephrology and
Hypertension, Rush University Medical Center, Chicago, IL, USA
2
NHS Vascular at SSM Health Saint Mary’s Health Center, St. Louis,
MO, USA
3
Transonic Systems, Ithaca, NY, USA
4
Richmond Vascular Center, North Chesterfield, VA, USA
5
Tarrant Nephrology, Fort Worth, TX, USA
6
Access Solutions, Des Plaines, IL, USA
7
SKI Vascular Center, Tempe, AZ, USA
8
Division of Interventional Radiology, University of Toronto, Toronto,
ON, Canada
9
Division of Nephrology and Department of Medicine, Emory
University School of Medicine, Atlanta, GA, USA
889793JVA 0 0 10.1177/1129729819889793The Journal of Vascular AccessWasse et al.
review-article 2019
Review
10
Department of Medicine, The Ohio State University Wexner Medical
Center, Columbus, OH, USA
11
Department of Medicine, Louisiana State University Health
Shreveport School of Medicine, Shreveport, LA, USA
12
Department of Medicine, University of Toronto, Toronto, ON, Canada
13
Department of Vascular Surgery, University of Oklahoma School of
Community Medicine, Tulsa, OK, USA
Corresponding author:
Haimanot Wasse, Department of Internal Medicine and Division of
Nephrology and Hypertension, Rush University Medical Center, 1717
W Congress Parkway, Kellogg Building, Suite 1026, Chicago, IL 60612,
USA.
Email: Monnie_Wasse@rush.edu