Rethinking an effective AV fistula-graft screening program. An "A B C"

Area of Science:

• Nephrology
• Vascular Surgery
• Healthcare Management

Background:

• Vascular access screening aims to detect and correct hemodynamically significant stenosis.
• Balancing aggressive screening with procedure risks and the dangers of no screening (access failure, central venous catheter use) is difficult.
• Guidelines support arterio-venous access monitoring, but management strategies remain debated.

Purpose of the Study:

• To explore optimal practice patterns for vascular access screening programs.
• To identify key elements for successful implementation and long-term vascular access preservation.
• To discuss the role of multidisciplinary teams, nurses, and patient empowerment.

Main Methods:

• Review of current guidelines and practice patterns in vascular access monitoring.
• Discussion of challenges in balancing screening intensity and access preservation.
• Emphasis on personalized, patient-shared, and tailored screening approaches.

Main Results:

• No definitive practice pattern for vascular access screening programs is established.
• Multidisciplinary effort, skilled nursing engagement, and patient empowerment are crucial.
• Personalized, patient-centered screening tailored to access type and site is recommended.

Conclusions:

• Successful vascular access screening requires a personalized, collaborative approach.
• Patient empowerment and skilled nursing involvement are vital components.
• Future advancements in technology and artificial intelligence may aid in predicting vascular access failure.