Novel Approaches to Arteriovenous Access Creation, Maturation, Suitability, and Durability for Dialysis

Maria V DeVita; San Kyaw Khine; Hristo Shivarov

doi:10.1016/j.ekir.2020.02.1024

Novel Approaches to Arteriovenous Access Creation, Maturation, Suitability, and Durability for Dialysis

Kidney Int Rep. 2020 Mar 3;5(6):769-778. doi: 10.1016/j.ekir.2020.02.1024. eCollection 2020 Jun.

Authors

Maria V DeVita¹, San Kyaw Khine¹, Hristo Shivarov¹

Affiliation

¹ Division of Nephrology, Lenox Hill Hospital, Northwell Health, Zucker School of Medicine, New York, New York, USA.

Abstract

Since the arteriovenous fistula (AVF) was first conceived over 50 years ago, the goal to create a vascular conduit with predictable and reproducible maturation and durability continues to elude caregivers. Recently, however, advances in the understanding of vascular biology and new technologies now provides us with some optimism; we are moving toward a viable solution. A quickly maturing, sustainable, and durable arteriovenous access may soon be attainable. This review will discuss these advances. There are novel approaches to AVF creation and devices to enhance maturation, advances in arteriovenous graft material(s), and devices to safely prolong the use of tunneled dialysis catheters. Although hemodialysis (HD) access remains a complex problem, these innovations may lead the way to optimizing the care and the quality of life of those patients who have no choice but to proceed with HD.

Keywords: arteriovenous fistula; arteriovenous graft; chronic kidney disease; dialysis catheter; end-stage renal disease; neointimal hyperplasia.

Publication types

Review