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RACS ASC 2025
Comparison of open surgical and endovascular arteriovenous access creation for haemodialysis: a review
Poster
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Poster

Disciplines

Vascular Surgery

Presentation Description

Institution: Royal North Shore Hospital - NSW, Australia

Purpose: Arteriovenous fistula (AVF) are created and matured for end stage renal failure patients on haemodialysis. Historically, they are created via an open surgical approach. With modern advancements, there are new technology to create AVF via a minimally invasive percutaneous approach, called endovascular AVF. This review aims to compare the outcomes of endovascular AVF creation and open surgical creation. Methodology: A literature review was performed in MedLine, PubMed, Embase, GoogleScholar for search terms “arteriovenous fistulas”, “endovascular”, “open”, and “surgical”. All relevant articles were included. Results: A total of seven articles were included in this review. Five articles compared functional and patency related outcomes and two articles compared the cost-effectiveness of each technique. There was no significant difference when comparing outcomes of procedural success, complications, or primary patency. There was heterogeneity between studies. The two cost-effective analysis studies were performed in Italy and in United States, which yielded contrasting results. Conclusion: Percutaneous fistula creation is a safe alternative with outcomes comparable to conventional open fistula creation with respect to maturation, patency, and reintervention rates. Further prospective observational studies are required to evaluate the long-term functional outcomes of endovascular AVF compared to surgically created AVF. Cost-effectiveness analysis outcomes varied with countries. A cost-effective analysis of the two techniques in the Australian healthcare system should be considered.
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Authors
Authors

Dr Shirley Cai - , Dr Animesh Singla -