Percutaneous endovascular arteriovenous fistula creation for hemodialysis access using "off-the-shelf" conventional devices.
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ABSTRACT:
SUBMITTER: Lobato M
PROVIDER: S-EPMC7683226 | biostudies-literature | 2020 Dec
REPOSITORIES: biostudies-literature
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Percutaneous endovascular arteriovenous fistula creation for hemodialysis access using "off-the-shelf" conventional devices.
Lobato Marta M Hernández Vaquero Jesús Ángel JÁ Fonseca Juan Luis JL
Journal of vascular surgery cases and innovative techniques 20200718 4
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Project description:ObjectivesThe aim of the present study was to perform cost-effectiveness and budget impact analyses comparing endovascular arteriovenous fistula creation to surgical arteriovenous fistula creation in hemodialysis patients from the National Healthcare Service (NHS) perspective in Italy.MethodsA systematic literature review has been conducted to retrieve complications' rates after arteriovenous fistula creation procedures. One study comparing endovascular arteriovenous fistula creation, performed with WavelinQ device, to the surgical approach through propensity score matching was preferred to single-arm investigations to execute the economic evaluations. This study was chosen to populate a Markov model to project, on a time horizon of 1 year, quality adjusted life years and costs associated with endovascular arteriovenous fistula (WavelinQ) and surgical arteriovenous fistula options for both cohorts of incident and prevalent hemodialysis patients.ResultsFor both incident and prevalent hemodialysis patients, endovascular arteriovenous fistula creation, performed with WavelinQ, was the dominant strategy over surgical arteriovenous fistula approach, showing less cost and better patients' quality of life. Compared to the current scenario, progressively increasing utilization rates of WavelinQ over surgical arteriovenous fistula creation in the next 5 years in incident hemodialysis patients are expected to save globally 30-36 million euros to the NHS.ConclusionEndovascular arteriovenous fistula creation performed with WavelinQ could be a cost-saving strategy in comparison with the surgical approach for patients in hemodialysis. Future studies comparing different devices for endovascular arteriovenous fistula creation versus the surgical option would be needed to confirm or reject the validity of this preliminary evaluation. In the meantime, decision-makers can use these results to take decisions on the diffusion of endovascular procedures in Italy.
| S-EPMC7897778 | biostudies-literature
Project description: Not available
| S-EPMC8353338 | biostudies-literature
Project description:Arteriovenous fistula (AVF) is the preferred vascular access for patients undergoing hemodialysis and the majority of AVFs fail because of venous intimal hyperplasia (VNH). Results from our lab have shown that adipose tissue-derived mesenchymal stem cell (MSC) transplantation to the adventitia of the outflow vein of AVF attenuates VNH in an immunodeficient mice. In the present study efficacy of Human AMSCs transplantation in treating AVF failure was tested in FoxN1 Nude mice with surgically created AVF. To explore the molecular mechanisms involved in MSCs transplantation improving AVF durability, we performed RNA-seq transcriptome analysis of the outflow veins of AVFs excised from mice 3 days after adventitial transplantation of MSCs.
2025-07-07 | GSE223511 | GEO
Project description:This SuperSeries is composed of the SubSeries listed below.
2025-07-07 | GSE179959 | GEO
Project description:Stenosis from venous neointimal hyperplasia is common in native arteriovenous fistulas (AVFs). However, the preexisting histologic characteristics of veins at fistula creation, and associations thereof with baseline patient factors, have not been well characterized. In this study, we conducted histologic analysis of a segment of the vein used for anastomosis creation, obtained during AVF creation from 554 of the 602 participants in the multicenter Hemodialysis Fistula Maturation Cohort Study. We quantified intimal and medial areas and lengths of the internal and external elastic lamina by morphometry and assessed venous wall cells by immunohistochemistry, extracellular matrix with Movat stain, and calcium deposition by alizarin red stain. We also studied a representative subset of veins for markers of monocyte/macrophage content, cell proliferation, apoptosis, and neoangiogenesis. Neointima occupied >20% of the lumen in 57% of fully circumferential vein samples, and neointimal hyperplasia associated positively with age and inversely with black race. The neointima was usually irregularly thickened, sometimes concentric, and contained α-smooth muscle actin-expressing cells of smooth muscle or myofibroblast origin. Proteoglycans admixed with lesser amounts of collagen constituted the predominant matrix in the neointima. In 82% of vein samples, the media of vessel walls contained large aggregates of collagen. A minority of veins expressed markers of inflammation, cell proliferation, cell death, calcification, or neoangiogenesis. In conclusion, we observed preexisting abnormalities, including neointimal hyperplasia and prominent accumulation of extracellular matrix, in veins used for AVF creation from a substantial proportion of this cohort.
| S-EPMC5619951 | biostudies-literature
Project description:Arteriovenous fistula (AVF) is the preferred vascular access for patients undergoing hemodialysis and the majority of AVFs fail because of venous intimal hyperplasia (VNH). Results from our lab have shown that adipose tissue-derived mesenchymal stem cell (MSC) transplantation to the adventitia of the outflow vein of AVF attenuates VNH in an immunodeficient mice. in the present study efficacy of AMSCs transplantation in treating AVF failure was tested in a chronic kidney disease (CKD) followed by an AVF created in C57BL/6 mice and porcine models as described in methods. Moreover, a phase 1 trial was performed in small group of endstage renal disease (ESRD) patients who are in hemodialysis. To explore the molecular mechanisms involved in MSCs transplantation improving AVF durability, we performed RNA-seq transcriptome analysis of the outflow veins of AVFs excised from mice and Pigs the after adventitial transplantation of MSCs from the donor inbred C57BL/6 mice or pigs respectively. RNA-seq on AMSCs isolated from donor mice, pigs and from patients of Phase 1 study was performed and CD markers of MSCs were compared to assess the homogenicity of isolated AMSCs with in the species.
2025-07-07 | GSE179957 | GEO
Project description:ObjectiveCurrently, percutaneous endovascular creation of arteriovenous fistula (AVF) shows excellent outcomes. However, few systematic research evidence to support clinical decision making on the benefit of endovascular AVF is available. The purpose of this study was to evaluate the efficacy and safety of endovascular AVF (endoAVF) in patients with renal failure.MethodsWe searched the Medline, Embase, Cochrane Library, and ClinicalTrials.gov databases for studies on endovascular or endovascular versus surgery for the creation of AVF. Two reviewers independently selected studies and extracted data. A systematic review and meta-analysis were performed by Review Manager 5.4 software (Revman, The Cochrane Collaboration, Oxford, United Kingdom) and Stata 15.0 (Stata Corp, College Station, TX, United States).ResultsA total of 14 case series and 5 cohort studies, with 1,929 patients, were included in this study. The technique success was 98.00% for endoAVF (95% CI, 0.97-0.99; I 2 = 16.25%). There was no statistically significant difference in 3 cohort studies between endovascular and surgical AVF for procedural success (OR = 0.69; 95% CI, 0.04-11.98; P = 0.80; I 2 = 53%). The maturation rates of endoAVF were 87.00% (95% CI, 0.79-0.93; I 2 = 83.96%), and no significant difference was observed in 3 cohort studies between the 2 groups (OR = 0.73; 95% CI, 0.20-2.63; P = 0.63; I 2 = 88%). Procedure-related complications for endoAVF was 7% (95% CI, 0.04-0.17; I 2 = 78.31%), and it did not show significant difference in 4 cohort studies between the 2 groups (OR = 1.85; 95% CI, 0.37-9.16; P = 0.45; I 2 = 59%).ConclusionThe endovascular creation of AVF is potentially effective and safe. These important data may provide evidence to support clinicians and patients in making decisions with endovascular AVF. But further research is great necessary due to lack of randomized controlled studies.
| S-EPMC9486211 | biostudies-literature
Project description:Arteriovenous fistula (AVF) is the preferred vascular access for patients undergoing hemodialysis and the majority of AVFs fail because of venous intimal hyperplasia (VNH). Results from our lab have shown that adipose tissue-derived mesenchymal stem cell (MSC) transplantation to the adventitia of the outflow vein of AVF attenuates VNH in an immunodeficient mice. in the present study efficacy of AMSCs transplantation in treating AVF failure was tested in a chronic kidney disease (CKD) followed by an AVF created in C57BL/6 mice and porcine models as described in methods. Moreover, a phase 1 trial was performed in small group of endstage renal disease (ESRD) patients who are in hemodialysis. To explore the molecular mechanisms involved in MSCs transplantation improving AVF durability, we performed RNA-seq transcriptome analysis of the outflow veins of AVFs excised from mice and Pigs the after adventitial transplantation of MSCs from the donor inbred C57BL/6 mice or pigs respectively. RNA-seq on AMSCs isolated from donor mice, pigs and from patients of Phase 1 study was performed and CD markers of MSCs were compared to assess the homogenicity of isolated AMSCs with in the species.
2025-07-07 | GSE179955 | GEO
Project description:Arteriovenous fistula (AVF) is the preferred vascular access for patients undergoing hemodialysis and the majority of AVFs fail because of venous intimal hyperplasia (VNH). Results from our lab have shown that adipose tissue-derived mesenchymal stem cell (MSC) transplantation to the adventitia of the outflow vein of AVF attenuates VNH in an immunodeficient mice. in the present study efficacy of AMSCs transplantation in treating AVF failure was tested in a chronic kidney disease (CKD) followed by an AVF created in C57BL/6 mice and porcine models as described in methods. Moreover, a phase 1 trial was performed in small group of endstage renal disease (ESRD) patients who are in hemodialysis. To explore the molecular mechanisms involved in MSCs transplantation improving AVF durability, we performed RNA-seq transcriptome analysis of the outflow veins of AVFs excised from mice and Pigs the after adventitial transplantation of MSCs from the donor inbred C57BL/6 mice or pigs respectively. RNA-seq on AMSCs isolated from donor mice, pigs and from patients of Phase 1 study was performed and CD markers of MSCs were compared to assess the homogenicity of isolated AMSCs with in the species.
2025-07-07 | GSE179954 | GEO
Project description:Arteriovenous fistula (AVF) is the preferred vascular access for patients undergoing hemodialysis and the majority of AVFs fail because of venous intimal hyperplasia (VNH). Results from our lab have shown that adipose tissue-derived mesenchymal stem cell (MSC) transplantation to the adventitia of the outflow vein of AVF attenuates VNH in an immunodeficient mice. in the present study efficacy of AMSCs transplantation in treating AVF failure was tested in a chronic kidney disease (CKD) followed by an AVF created in C57BL/6 mice and porcine models as described in methods. Moreover, a phase 1 trial was performed in small group of endstage renal disease (ESRD) patients who are in hemodialysis. To explore the molecular mechanisms involved in MSCs transplantation improving AVF durability, we performed RNA-seq transcriptome analysis of the outflow veins of AVFs excised from mice and Pigs the after adventitial transplantation of MSCs from the donor inbred C57BL/6 mice or pigs respectively. RNA-seq on AMSCs isolated from donor mice, pigs and from patients of Phase 1 study was performed and CD markers of MSCs were compared to assess the homogenicity of isolated AMSCs with in the species.Mesenchymal Stem Cell Transplantation Attenuates Venous Stenosis of Hemodialysis Vascular Access Arteriovenous Fistula
2025-07-07 | GSE179953 | GEO