Arteriovenous access does not perform as well for plasmapheresis

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Nephrology

Background:

• Arteriovenous access is crucial for various medical procedures.
• Non-dialysis applications, such as apheresis, also require vascular access.
• Current outcomes for apheresis access are subjectively poor.

Purpose of the Study:

• To evaluate the experience and outcomes of arteriovenous access creation specifically for apheresis.
• To compare these outcomes with those typically seen in hemodialysis access.

Main Methods:

• Retrospective review of billing records (CPT and ICD-9 codes) from January 2007 to August 2014.
• Identification of patients undergoing arteriovenous access for non-renal failure indications.
• Analysis of patient demographics, treatments, access characteristics, patency, and reinterventions.

Main Results:

• 16 procedures for 8 patients (1.6% of total access creations) were performed for conditions like myasthenia gravis and polyneuropathy.
• High failure rates: 7 thrombosis, 4 non-maturation, 1 infection/steal syndrome.
• Overall maturation rate was 37.5%; mean primary patency was 236 days. Cumulative 1-year patency was 25%.

Conclusions:

• Arteriovenous access for apheresis constitutes a small fraction of access procedures.
• Patency and maturation rates are significantly lower than for hemodialysis access.
• High failure rates necessitate careful consideration when opting for surgical access over temporary catheters for non-hemodialysis purposes.