AVF Maturation
1. Arteriovenous Fistula (AVF) Maturation Although AVFs are the preferred form of dialysis vascular access, over 60% of surgically created AVFs are not suitable for dialysis between 4-5 months post surgery; often resulting in prolonged catheter dependency. Observational and randomized studies which could focus on one or all of the following are desperately needed: (a) pre-surgery arterial and venous vascular evaluation ...more »
1. Arteriovenous Fistula (AVF) Maturation
Although AVFs are the preferred form of dialysis vascular access, over 60% of surgically created AVFs are not suitable for dialysis between 4-5 months post surgery; often resulting in prolonged catheter dependency. Observational and randomized studies which could focus on one or all of the following are desperately needed: (a) pre-surgery arterial and venous vascular evaluation (b) surgical technique including experience of operator (c) physical and pharmacological therapy at different temporal periods following creation, (d) endovascular and surgical intervention for the non-maturing access (e) evaluation of novel local therapeutic interventions to enhance AVF maturation (cells, drugs, chemicals, genes and devices) (f) optimization of upstream hemodynamics (g) advances in cannulation technologies (h) process of care interventions focused on logistics and communication. This idea was identified as a priority area of research by the ASN Interventional Nephrology Advisory Group and the American Society of Interventional Nephrology.
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