Arteriovenous complication rate

Due to fewer complication and longer survival rates, the native arteriovenous fistula is the preferred access for hemodialysis. Venous catheters are plagued by complications such as infection and thrombosis and often deliver relatively poor blood flow rates. 

Approximately 1 in 856 people will undergo kidney dialysis, resulting in over 354,000 patients in the US alone [59], During the process, blood is transferred and processed at a rate of 350 mL min via arteriovenous fistulas, which act as a permanent access point to the vasculature [60], Complications due to the hemodynamic stress (wall shear stress) induced by the dialysis needle have been observed. The presence of the outflow needle has been shown to increase turbulence intensities dramatically [61], which in turn increases wall shear stresses, induces intimal hyperplasia, and causes stenosis [60],... 

The complication and patency rates of PTFE and PU grafts implanted for hemodialysis vascular access were compared by Kiyama et al. " by a long-term follow up of 53 patients who received 58 arteriovenous grafts between 1997 and 2000. Both problem-free (primary) and functional (secondary) patency rates for PU and PTFE grafts were similar at 1 year and 2 years. 

Thrombotic events represent the most frequent complication of all VA with an incidence rate of 0.2/patient/year for arteriovenous fistula (AVF) and 0.8/pa-tient/year for synthetic arteriovenous graft (AVG) [3]. Therefore, redo surgery is the rule rather than exception in VA patients. 

When a clinical complication occurs, arteriovenous fistulas and pseudoaneurysms can be effectively treated by transcatheter embolization, using superselective catheterization, which is a very efficient technique, providing a 95% technical success rate (Perini et al. 1998). To avoid occlusion of normal renal branches and to preserve renal function, microcoils are positioned as far as possible into the feeding artery(ies) of the fistula or into the neck of the pseudoaneurysm using coaxial catheters. 

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