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Related Experiment Video

Updated: Jul 8, 2026

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
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Published on: April 1, 2022

Early and late fistula failure.

C Mercado1, L Salman, G Krishnamurthy

  • 1Division of Nephrology Section of Interventional Nephrology, University of Miami Miller School of Medicine, Miami, FL 33136, USA.

Clinical Nephrology
|January 26, 2008
PubMed
Summary

Arteriovenous fistulas (AVFs) for hemodialysis can fail early or late. Percutaneous interventions and endovascular techniques can successfully salvage most failed AVFs, maximizing their use and minimizing catheter dependence.

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Last Updated: Jul 8, 2026

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
07:30

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A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail
10:10

A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail

Published on: February 3, 2016

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Arteriovenous fistulas (AVFs) are the preferred hemodialysis access but frequently experience early or late failure.
  • Early AVF failure is primarily caused by venous stenosis or accessory veins, while late failure can result from thrombosis.
  • Minimizing catheter use is crucial for hemodialysis patients, as highlighted by the National Kidney Foundation Dialysis Outcomes Quality Initiative.

Purpose of the Study:

  • To evaluate the efficacy of percutaneous interventions and endovascular techniques in salvaging failing arteriovenous fistulas.
  • To assess the success rates of declotting thrombosed fistulas using various endovascular methods.
  • To emphasize the importance of AVF salvage strategies in maximizing access longevity and patient outcomes.

Main Methods:

  • Percutaneous transluminal angioplasty for venous stenosis.
  • Thromboaspiration techniques for managing thrombosed fistulas with varying thrombus burdens.
  • Review of recent data on the outcomes of endovascular salvage procedures for AVFs.

Main Results:

  • A significant majority of early AVF failures due to stenosis or accessory veins can be successfully treated with percutaneous interventions.
  • Most thrombosed fistulas, regardless of thrombus volume, can be successfully declotted using endovascular techniques like angioplasty or thromboaspiration.
  • Salvage interventions restore AVF functionality, enabling dialysis and reducing reliance on central venous catheters.

Conclusions:

  • Endovascular interventions are highly effective in salvaging both early and late failing arteriovenous fistulas.
  • Successful declotting and angioplasty of AVFs significantly improve access availability for hemodialysis.
  • Maximizing AVF use through timely salvage strategies is essential for optimal patient care and outcomes in hemodialysis.