Arteriovenous Fistula, Renal Failure
Conditions
Keywords
arteriovenous fistula, surveillance, arterial stenosis, venous stenosis
Brief summary
Newly formed dialysis fistulae can often fail, and failure is usually due to narrowing of the blood vessels. Methods of detecting narrowing are available and, more importantly, can detect narrowings before a fistula fails. It is not known whether treating these narrowings will actually improve fistula survival or if the majority can be left alone. we wish to see if we can detect such narrowings with ultrasound scanning and if early detection and treatment improves patient outcomes.
Interventions
PROCEDUREActive ultrasound surveillance of fistula and proactive treatment of stenosis
Regular duplex ultrasound assessment of fistula from time of creation until 6 months post procedure with referral of all haemodynamically significant stenoses to further imaging and treatment
Sponsors
University of Hull
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Incident patients referred to vascular or transplant surgery departments for primary AV fistula formation for haemodialysis access. 2. Ability to give informed written consent 3. Aged over 18 at time of referral
Exclusion criteria
1. Inability to give informed written consent 2. Aged under 18 at time of referral 3. Inability to attend follow-up appointments Specific exclusion; 1. Previous arteriovenous access procedures in target limb 2. Unsuitable for upper limb radiocephalic or brachiocephalic AVF formation 3. Known thrombophilic or thrombotic pathology
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cumulative or secondary patency | within 6 months of fistula formation | This being the interval from the time of access placement until access abandonment, thrombosis, or the time of patency measurement including intervening manipulations (surgical or endovascular interventions) designed to re-establish functionality in thrombosed access. |
Secondary
| Measure | Time frame |
|---|---|
| Number of thrombosis events | within 6 months of fistula formation |
| Number of fistula failures | within 6 months of fistula formation |
| Number, type and technical success rate for elective interventions | within 6 months of fistula formation |
| Number, type and technical success rate of acute interventions | within 6 months of fistula formation |
Countries
United Kingdom
Outcome results
None listed