Mid-term results of percutaneous arteriovenous fistula creation with the Ellipsys vascular access system, technical recommendations and an algorithm for maintenance

Alexandros Mallios, Pierre Bourquelot, Gilbert Franco, Hadia Hebibi, Hortence Fonkoua, Mahmoud Allouache, Alessandro Costanzo, Romain de Blic, Ghazi Harika, Benoit Boura, William C. Jennings
2020 Journal of Vascular Surgery  
The aim of this study is to report our mid-term results of percutaneous arteriovenous fistula (pAVF) creation using the Ellipsys device and present technical recommendations and our algorithm of pAVF maintenance. A single center comprehensive database of all consecutive pre-dialysis and end-stage renal disease patients that had a pAVF creation with the Ellipsys® device was reviewed retrospectively. Study endpoints included technical success, maturation, functional patency and required
more » ... ons. Between May 2017 and July 2019, 234 patients (mean age 64, 148 males - 63%) had a pAVF created. Technical success was achieved in 232 individuals (99%) and average duration of the procedure was 15 minutes (7-35minutes). Average follow up was 252 days (range 83-696). One year, primary, primary assisted and secondary patency were 54%, 85% and 96%, respectively. Average pAVF flow was 923ml/min (range 425-1440). There were no significant adverse events related to the procedure. Only 3 patients (1%) required a later conversion of the pAVF anastomosis to a surgical fistula. Twenty-four (10%) patients required superficialization of deep outflow veins due to difficult cannulation. Average maturation time was 4 weeks (range 1-12 weeks). Fourteen patients (6%) had early (< 2 weeks after creation) cannulation of their pAVF. The Ellipsys® pAVF device allows for the rapid and safe creation of a reliable autogenous access. Rates of technical success, patency and maturation were excellent. For patients unsuited for a distal radio-cephalic arteriovenous fistula, it should be considered the next preferred access option.
doi:10.1016/j.jvs.2020.02.048 pmid:32276012 fatcat:b2fvrm2lvbaw5fl73lwd6zmwce