Abstract: FR-PO530
Closure of an Endovascular Arteriovenous Fistula Initially Created for Dialysis Access by Placement of Radial Artery Covered Stent
Session Information
- Dialysis Vascular Access
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Quintero Alvarez, Hector, Universidad Central Del Caribe, Bayamon, Puerto Rico
- Claudio-Rodriguez, Carlos, Azura Vascular Care, Juana Diaz, Puerto Rico, United States
- Peguero, Julio A., Azura Vascular Care, Juana Diaz, Puerto Rico, United States
- Hernandez-Arroyo, Cesar F., Universidad Central Del Caribe, Bayamon, Puerto Rico
Introduction
Endovascular arteriovenous fistula (eAVF) creation offers a minimally invasive technique for creating arteriovenous fistulas for hemodialysis. The Ellipsys® System has demonstrated safety and effectiveness in creating eAVFs. However, questions remain regarding the optimal approach for reversing eAVFs when necessary. We present the first documented closure of a radial artery to perforator vein eAVF using a proximal radial artery covered stent.
Case Description
50-year-old man with end-stage renal disease on hemodialysis sought closure of his eAVF due to chronic left upper arm swelling attributed to total occlusion of left innominate vein. Ultrasound confirmed patency and flow of the radial and ulnar arteries. The radial artery was cannulated, patient heparinization, and a catheter and guidewire were advanced into the brachial artery for direct arteriogram to identify the anatomy and arterial anastomosis. A Gore Viabhan endoprosthesis was deployed under fluoroscopic guidance, angioplasty done to anchor stent, and finally a direct brachial artery arteriogram confirmed occlusion of eAVF anastomosis.
Discussion
As proceduralists gain more experience, they become increasingly adept at maintaining this new type of access. Our aim is to provide insights into the potential closure of eAVFs and remain optimistic about the improved quality of care and reduced overall health complications this innovative technology offers.