ArticleFrontiers in medicine2026
Clinical outcomes of ultrasound-guided percutaneous arteriovenous fistula creation for maintenance hemodialysis access.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To retrospectively analyze the clinical outcomes of applying ultrasound-guided percutaneous arteriovenous fistula (pAVF) creation technology for maintenance hemodialysis access at DeYu Medical Ma'anshan General Hospital. Methods: A total of 64 maintenance hemodialysis patients who underwent ultrasound-guided pAVF creation at DeYu Medical Ma'anshan General Hospital between January 1, 2020, and December 31, 2023,and were followed up until June 2024 were selected. Patient demographic data, pAVF maturation, patency rates, complications, and secondary interventions required to maintain patency were collected and analyzed. Results: The technical success rate of pAVF creation was 96.9% (62/64). The functional maturation rate at 90 days postoperatively was 89.1% (57/64), defined as successful two-needle cannulation for ≥6 adequate dialysis sessions. The median time to first successful cannulation was 42 days (IQR: 35-56), with a mean pump blood flow of 312 ± 18 mL/min achieved during dialysis, and all functionally mature fistulas delivered adequate hemodialysis (single-pool Kt/V ≥ 1.2). During a median follow-up of 28 months (range: 6-54 months), the cumulative primary patency, assisted primary patency, and secondary patency rates at 1 year were 78.1, 89.1, and 92.2%, respectively, and at 2 years were 70.3, 85.9, and 89.1%, respectively. A total of 29.7% (19/64) of patients underwent secondary interventions aimed at maintaining or restoring fistula function, with an average intervention rate of 0.41 per patient per year. Major complications included thrombosis (7.8%), cannulation site stenosis or hematoma (10.9%), and outflow vein stenosis(9.4%). No device- or procedure-related serious adverse events, such as steal syndrome or severe infection, occurred. Conclusion: Our single-center experience suggests that ultrasound-guided percutaneous arteriovenous fistula creation appears to be a safe and effective method for establishing hemodialysis access, with high technical success and functional maturation rates, good mid-to-long-term patency rates, and a low incidence of complications. These findings are hypothesis-generating and require validation in larger prospective studies.
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