Impact of interventions in endovascular arteriovenous fistula created using the WavelinQ 4-F EndoAVF system on personalised vascular access strategy for patients with end-stage renal disease

Purpose The aim of the study was to evaluate the interventions in endoAVF created with the WavelinQ 4-F EndoAVF system to clarify the role of this method in personalised vascular access strategy for end-stage renal disease patients. Material and methods Endovascular fistula creation was performed in 16 patients. The type of additional endovascular procedures during fistula creation was evaluated. Postoperative surgical and endovascular intervention was divided into maintenance and enhanced maturation procedures. The necessity of using assisted maturation was examined by Kaplan-Meier analysis, the rate of interventions per patients per year and evaluation of the type, time, and the relationship between intraoperative and postoperative interventions. Results Access primary patency was significantly lower than access cumulative and functional patency (p < 0.001). During endoAVF creation 73.3% patients required 16 additional endovascular procedures. After endoAVF creation 73.3% patients needed endovascular 22 procedures and 20% underwent surgical interventions. Nine (81.8%) out of 11 patients required intravascular procedures due to lack of fistula maturation – 9 (45%) angioplasties and 11 (55%) vein embolisations. The postoperative venous embolisation rate was significantly dependent on vein embolisation during endoAVF creation (p < 0.04). After endoAVF creation significantly more patients – 11 (73.3%) – required endovascular interventions compared to 3 (20%) with surgical interventions (p < 0.01). Postoperative endovascular and surgical interventions was 0.09 and 0.02 per patients per year, respectively. Conclusions Maturation of endoAVFs required significantly more endovascular than surgical interventions. Venous embolisation combined with fistula creation reduced postoperative embolisation.