Endovascular intervention in the maintenance and rescue of paediatric arteriovenous fistulae for hemodialysis

Petrut Gogalniceanu, Sam Stuart, Narayan Karunanithy, Nicos Kessaris, Derek Roebuck, Francis Calder*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Background: Arteriovenous fistulae (AVF) provide superior primary vascular access for children on chronic dialysis compared to central venous catheters (CVC). However, AVFs inevitably develop complications and will require some intervention to maintain long-term functional patency. Methods: We report an ‘endovascular-first’ approach to the maintenance and rescue of paediatric AVFs. Thirty interventions targeting 46 lesions in 18 children (median age 11 years [range 5–17]) were performed. Sixty-eight percent of the AVFs were brachio-cephalic fistulae, 26% brachio-basilic fistulae and 5% radio-cephalic fistulae. Immediate functional success was 86% with good dialysis adequacy (mean urea reduction ratio > 70%) at 3 months post procedure. Results: There was one significant complication, consisting of an AVF rupture which was managed with a covered stent. Conclusions: Repeated interventions may be necessary to maintain AVF patency and avoid central venous catheters. This is the largest series reported to date.

Original languageEnglish
Pages (from-to)723-727
Number of pages5
JournalPediatric Nephrology
Volume34
Issue number4
DOIs
Publication statusPublished - 1 Apr 2019

Keywords

  • Angioplasty
  • Arteriovenous fistulas
  • Endovascular
  • Haemodialysis
  • Vascular access

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