Presenter details new devices and technologies in vascular access
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Nephrologists have several options when it comes to new vascular access devices and technologies, according to a presentation at the Innovations in Dialysis: Expediting Advances Symposium.
Currently, there are two FDA-approved devices for preventing access dysfunction. These include the WavelinQ from BD, a dual catheter device that is placed under fluoroscopy, and Ellipsys from Medtronic, a single catheter electrocautery device that is placed under ultrasound.
A 24-month study revealed that 92% of patients using the Ellipsys device showed a patient arteriovenous fistula (AVF); therefore, the cumulative patency of the device is “very good.”
“The goal is to create an AVF between the proximal radial artery or the ulnar arteries and the deep adjacent vein with drainage via the perforator vein to the upper arm superficial veins,” Monnie Wasse, MD, MPH, the Muehrcke Professor of Nephrology and vice chair and director of interventional nephrology at Rush University Medical Center, said in the presentation.
Topics that future studies should focus on when it comes to percutaneous AVF (pAVF) are long-term patency, whether dialysis units can successfully cannulate them, whether it meets typical dialysis prescription and the percentage of patients eligible for pAVF, Wasse said.
Additional vascular access options include the radial artery deviation and reimplementation surgical technique, the VasQ device from Laminate Medical that provides external support of a patient’s vasculature to limit risk of arteriovenous fistula failure and the Alio Smartwatch for remote patient monitoring of AV access flow surveillance.
Wasse briefly discussed the AMPLIFI vein dilation system from Artio Medical, a wearable external blood pump with inflow and outflow catheters that creates rapid, non-pulsatile blood flow to pre-dilate draining veins. This device is designed to be worn for 14 days prior to AVF creation, and it is currently being evaluated.
“In my opinion, this is an invasive attempt that requires a port and a long catheter to effectively allow for rapid blood flow through the intended target vessel, but the originators of this state that there can be huge benefits in terms of potential patency down the road for patients,” Wasse said.
Wasse concluded the presentation by mentioning drug-coated balloons and the Surfacer Inside-Out Access Catheter System from Bluegrass Vascular as additional new technologies.
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Wasse M. New technologies for dialysis access creation & maintenance. Presented at: Innovations in Dialysis: Expediting Advances Symposium ; Aug. 15-16, 2022; Seattle (hybrid meeting).
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