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Author Spotlight: Hickman Catheter Use for Long-Term Vascular Access in a Preclinical Swine Model
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Reality check: primary vascular access creation today.

Tabitha Jann1, Thomas R Wyss1, Brigitta Gahl1

  • 1Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland.

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Summary
This summary is machine-generated.

Vascular access outcomes in Switzerland show low primary patency rates for arteriovenous fistulas and grafts. This highlights the need for improved vascular access creation and a national registry for better patient outcomes.

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Public Health

Background:

  • The outcome of vascular access creation for the 4500 dialysis patients in Switzerland is largely unknown due to the absence of a prospective registry.
  • Assessing the quality of vascular access and comparing it to literature and guidelines is crucial for improving clinical outcomes.

Purpose of the Study:

  • To evaluate the quality of vascular access creation in Switzerland.
  • To compare current practices with existing literature and guidelines.
  • To identify strategies for enhancing clinical outcomes in renal replacement therapy.

Main Methods:

  • A retrospective, single-center study was conducted at a tertiary referral center.
  • Included were 74 consecutive patients over 18 years old who underwent primary vascular access creation (arteriovenous fistula or graft) between January 2013 and December 2014.
  • Follow-up data for at least 12 months were collected.

Main Results:

  • The 1-year primary patency rate was 46% for arteriovenous fistulas (AVF) and 30% for arteriovenous grafts (AVG).
  • The 1-year secondary patency rate was 75% for AVF and 50% for AVG.
  • 36% of patients with primary vascular access required central venous catheter (CVC) placement before access creation, and 50% had their first dialysis via CVC.

Conclusions:

  • The observed low primary patency rates and high CVC utilization underscore the need for improved vascular access management.
  • It is essential for centers to register their vascular access activities and benchmark outcomes against guidelines.
  • The national registry "SwissVasc 2.0" aims to facilitate data collection and comparison among Swiss vascular surgeons starting in 2018.