Percutaneous endovascular arteriovenous fistula: A systematic review and meta-analysis

Ji-Bo Sun; Chun-Cheng Liu; Xi Shen; Qin Chen; Cheng-Liang Xu; Tian-Lei Cui

doi:10.3389/fcvm.2022.978285

Percutaneous endovascular arteriovenous fistula: A systematic review and meta-analysis

Front Cardiovasc Med. 2022 Sep 6:9:978285. doi: 10.3389/fcvm.2022.978285. eCollection 2022.

Authors

Ji-Bo Sun¹, Chun-Cheng Liu², Xi Shen¹, Qin Chen³, Cheng-Liang Xu⁴, Tian-Lei Cui¹

Affiliations

¹ Department of Nephrology, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China.
² Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China.
³ Department of Endocrinology and Nephrology, 363 Hospital, Chengdu, China.
⁴ Department of Nephrology, Wuwei People's Hospital, Wuwei, China.

Abstract

Objective: Currently, percutaneous endovascular creation of arteriovenous fistula (AVF) shows excellent outcomes. However, few systematic research evidence to support clinical decision making on the benefit of endovascular AVF is available. The purpose of this study was to evaluate the efficacy and safety of endovascular AVF (endoAVF) in patients with renal failure.

Methods: We searched the Medline, Embase, Cochrane Library, and ClinicalTrials.gov databases for studies on endovascular or endovascular versus surgery for the creation of AVF. Two reviewers independently selected studies and extracted data. A systematic review and meta-analysis were performed by Review Manager 5.4 software (Revman, The Cochrane Collaboration, Oxford, United Kingdom) and Stata 15.0 (Stata Corp, College Station, TX, United States).

Results: A total of 14 case series and 5 cohort studies, with 1,929 patients, were included in this study. The technique success was 98.00% for endoAVF (95% CI, 0.97-0.99; I ² = 16.25%). There was no statistically significant difference in 3 cohort studies between endovascular and surgical AVF for procedural success (OR = 0.69; 95% CI, 0.04-11.98; P = 0.80; I ² = 53%). The maturation rates of endoAVF were 87.00% (95% CI, 0.79-0.93; I ² = 83.96%), and no significant difference was observed in 3 cohort studies between the 2 groups (OR = 0.73; 95% CI, 0.20-2.63; P = 0.63; I ² = 88%). Procedure-related complications for endoAVF was 7% (95% CI, 0.04-0.17; I ² = 78.31%), and it did not show significant difference in 4 cohort studies between the 2 groups (OR = 1.85; 95% CI, 0.37-9.16; P = 0.45; I ² = 59%).

Conclusion: The endovascular creation of AVF is potentially effective and safe. These important data may provide evidence to support clinicians and patients in making decisions with endovascular AVF. But further research is great necessary due to lack of randomized controlled studies.

Keywords: arteriovenous fistula; endovascular; meta-analysis; percutaneous; surgical.

Publication types

Systematic Review