Multidisciplinary working group: key role for percutaneous endovascular AV fistula program. Point of view

Area of Science:

• Nephrology
• Vascular Surgery
• Interventional Radiology

Background:

• Chronic kidney disease (CKD) affects over 10% of the global population.
• Hemodialysis is a common treatment for kidney failure, requiring vascular access.
• Percutaneous endovascular arteriovenous fistula (AVF) creation is an emerging alternative to surgical AVF.

Purpose of the Study:

• To highlight the advantages of the percutaneous endovascular AVF technique.
• To describe the organization and role of a multidisciplinary team in AVF management.
• To emphasize the importance of patient involvement and education in the AVF process.

Main Methods:

• Implementation of a multidisciplinary team including nephrologists, interventional radiologists, vascular surgeons, anesthesiologists, and dialysis nurses.
• Involvement of nephrologists in all stages: selection, mapping, creation, and follow-up of the endovascular AVF.
• Periodic evaluation of procedural outcomes and patient/family feedback for continuous improvement.

Main Results:

• The percutaneous endovascular AVF technique demonstrates promising results with several advantages over standard surgical creation.
• Multidisciplinary team collaboration is essential for the successful implementation of this technique.
• Patient empowerment, education, and involvement are integral to the management process.

Conclusions:

• The percutaneous endovascular AVF technique offers a promising approach for vascular access in hemodialysis.
• A multidisciplinary team approach, with significant nephrologist involvement, is key to successful endovascular AVF management.
• Further research is needed to confirm the benefits of multidisciplinary team management for end-stage kidney disease patients undergoing AVF procedures.