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The helix fistula.

Paul C Johnston1

  • 1Colorado Permanente Medical Group, Department of Vascular Therapy, Denver, Colo.

Journal of Vascular Surgery Cases
|November 15, 2019
PubMed
Summary

Autogenous spiral vein grafts offer a new option for hemodialysis access when traditional methods fail. This innovative helix fistula approach provides an alternative for patients lacking suitable veins for standard autogenous access.

Area of Science:

  • Vascular Surgery
  • Nephrology
  • Medical Devices

Background:

  • Current guidelines recommend autogenous vascular access for hemodialysis over prosthetic options.
  • Many patients are ineligible for traditional autogenous access due to small vein caliber (≤2 mm).
  • The Fistula First Breakthrough Initiative promotes autogenous access to improve patient outcomes.

Observation:

  • This report details the initial clinical experience with a novel autogenous hemodialysis access.
  • The new access method utilizes autogenous spiral vein grafts, termed helix fistulas.
  • This technique addresses the challenge of limited suitable vein size in the upper extremities.

Findings:

  • Helix fistulas represent a new class of autogenous hemodialysis access.

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  • Initial experiences suggest feasibility in patients with previously unfeasible autogenous access options.
  • The spiral graft design may overcome limitations posed by small native vein diameters.

    • Implications:

    • This novel approach could expand the options for creating effective autogenous hemodialysis access.
    • Helix fistulas may improve the rate of successful autogenous access creation in challenging patient populations.
    • Further research is warranted to evaluate the long-term efficacy and safety of helix fistulas.