Kidney disease is a condition affecting millions of people across the United States and the world at large. With the help of science and its progress over the decades, the condition is a manageable one, with various interventions, medications, and lifestyle interventions that make it possible for those affected to continue living full and productive lives.
The introduction of is the EndoAVF is one of the latest developments in this field of medicine, which stands for the Endovascular Creation of an Arteriovenous Fistula. Here’s a simplified but thorough look at some of the key elements you might like to know when it comes to this procedure, including what to expect as a potential client of the vascular experts at PedesOC.
EndoAVF: What it is and What Role it Plays
The EndoAVF procedure is basically creating a suitable access point to a patient’s circulatory system that allows for the carrying out of the hemodialysis procedure. Gaining access to the vascular system is a key initial step in managing end-stage-renal-disease (ESRD), otherwise known as kidney failure. This is where the kidneys of a person’s body cannot keep up with the important role it plays in filtering out waste and toxins from the body, typically released in urine.
ESRD patients experience a gradual accumulation of these unwanted substances in their bloodstreams, which might eventually see them enter toxic shock or eventual death. This is unless they are fortunate enough to receive a kidney transplant or undergo regular dialysis treatments. For many, the kidney transplant option might belong in the waiting, meaning dialysis treatment is a vital procedure for most renal patients.
Now, hemodialysis (dialysis) is a procedure where the patient’s ‘dirty’ blood is mechanically filtered by being drawn out of their body, passed through a dialysis (filtration) machine, then reintroduced into their vascular system without toxins and waste it previously contained.
The point to note here is that the entrance and exit point of the blood flowing into and out of the patient is referred to as the vascular access point. Creating this access point is the entire purpose of carrying out the EndoAVF procedure, and it is what vascular specialists are there for.
What is Involved in this Procedure
We mentioned the fact that the EndoAVF procedure is a relatively new innovation in this field, so you might be asking yourself – what came before it? The creation of an arteriovenous fistula (AVF) used to be conducted surgically. Surgeons would make incisions on the patient’s arm, manually reconfigure the vessels underneath so that an artery flows into an adjacent vein, and then close up the site. This complex procedure would often result in unsightly scarring, not to mention the high rates of failure reported.
The functionality behind connecting an artery to a vein in the patient’s forearm causes the vein to become enlarged and its walls to thicken due to the increased pressure it experiences. After a few weeks to a month, it will have ‘matured,’ meaning it is ready to handle the dialysis process that will take place along this mature section of the patient’s vascular system. This is the all-important vascular access point we keep mentioning.
The innovation that is the EndoAVF procedure lies in the Endo- PART. It refers to the fact that non-surgical methods create the vascular access point suitable for the dialysis process. In the EndoAVF process, specialists will make use of a dual magnetic catheter system. These are basically two very slim implements inserted into one suitably selected artery and vein either through the upper arm or through the wrist.
After being guided along their selected pathways through fluoroscopic imaging, they will be halted at the chosen location to create the fistula (the place where the artery will join up with the vein). Here, a radiofrequency burst of energy will be released, creating a channel or link opening between the two implements. The arteriovenous fistula will thus have been established non-surgically.
It will then be a matter of simply withdrawing the implements through their tiny openings and leaving the access point to ‘mature’ and ready for dialysis treatment. It is estimated that 90% of people have suitable vascular configurations to have this procedure carried out successfully.
Benefits of Choosing EndoAVF
Success rates: Studies conducted across the United States, Canada, and Europe have found that EndoAVF procedures have much higher success rates than other AVF methods. One study produced 32 successful procedures out of 33 patients, translating to a 96.2% success rate, which is the norm in various studies.
Success in this instance is measured in terms of how well the actual procedure went (technical success), how often a patient will need to see their doctor due to complications after the procedure (intervention rates), and how long the AVF will be viable for dialysis treatments after the procedure (patency). An unsuccessful procedure will involve a failure of the access point to mature or other complications at the fistula site.
What to Expect from Your Visit to Pedes
Your treatment will begin with an ultrasound examination of your veins, arteries, or both, in your legs to diagnose the presence and extent of the disease. Your test results will be immediately available to review with the doctor.
Once we review the results of your diagnostic tests, our physicians will help you develop a plan to provide you with the best treatment for your disease.
Depending on the extent of disease in your arteries or veins, our specialists may recommend minimally invasive intervention and/or prescribe medications to help your symptoms.
It is important to make sure that you return for every scheduled follow-up appointment to ensure that your disease is appropriately monitored. If you ever have any questions or concerns, please call or schedule a follow-up appointment with our staff.