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Published on: April 1, 2022
Arteriovenous fistula cannulation by buttonhole technique using dull needle
Manuel Carlos Martins de Castro1, Celina de Fátima e Silva, João Marcos Rodrigues de Souza
1Instituto de Nefrologia de Taubaté, São Paulo, Brazil. dr.martinscastro@uol.com.br
Jornal Brasileiro De Nefrologia
|November 25, 2010
Summary
The buttonhole (BH) technique for arteriovenous fistula cannulation is easy to implement, safe, and reduces patient pain without affecting dialysis dose. This method offers a promising alternative for hemodialysis access.
Area of Science:
- Nephrology
- Vascular Access Surgery
Background:
- Arteriovenous fistulas (AVFs) are crucial for hemodialysis.
- Cannulation techniques for AVFs include area puncture, rope ladder, and buttonhole (BH).
- The optimal AVF cannulation technique remains undetermined.
Purpose of the Study:
- To evaluate the complications and challenges of adopting the BH cannulation technique for native vein AVFs.
- To assess the safety and efficacy of the BH technique in a dialysis unit setting.
Main Methods:
- Sixteen patients undergoing hemodialysis were transitioned to the BH technique.
- Track formation utilized sharp needles, while the maintenance phase employed blunt needles.
- Pain intensity was assessed on a 0-10 scale throughout the study.
Main Results:
- The BH technique demonstrated a low complication rate during 475 hemodialysis sessions.
- Reported complications included cannulation resistance (7.6%) and local bleeding (0.8%).
- Median pain intensity decreased from 4 to 2 after transitioning to blunt needle BH cannulation, with no change in dialysis dose (Kt/V).
Conclusions:
- The buttonhole technique with blunt needles is technically straightforward and safe for AVF cannulation.
- This method effectively reduces pain and maintains adequate dialysis dose.
- The BH technique presents a viable option for improving AVF cannulation in hemodialysis patients.
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