TPTh 6.10 The Use of Vasq External Supportive Device in Improving Arterio-Venous Fistula Patency

Abstract Aims Arterio-Venous Fistulas (AVFs) are a lifeline for patients on haemodialysis. The primary patency of AVFs is around 70%. External support devices, like VasQ, may improve flow dynamics, patency and reduce need for interventions. Methods We identified patients who underwent VasQ implantation and AVF formation. All had pre-op ultrasound mapping, identifying suitable vein and artery. Patients were reviewed in maturation clinic 6 weeks post-operatively with duplex scan and followed up in this single-centre prospective study. Results VasQ was implanted in fourteen patients (Male:Female 5:2, Median age 67.5 (range 45-86)), undergoing Brachiocephalic (n=10 and Brachiobasilic (n=4) AVF formation. Twelve of the patients had CKD stage 5, one AKCC (eGFR 10) and one a failing renal transplant (eGFR 13). One attempted fistula blocked on table and VasQ device removed. One patient developed post-op infection and sepsis requiring ICU admission and removal of VasQ within 10 days. On Duplex scan at 6-8 weeks, four (4/12=33%) had stenosis in the peri-anastomotic region with three of them undergoing fistuloplasty; another four (4/12=33%) had thrombosis of the fistula, two of which received anticoagulation treatment. At 6 months, none of the AVFs were being used. At 12 months, two were in use. At 24 months, three were in use (3/14=21%). Conclusion In our cohort, the externally supported AVF using VasQ did not lead to an increase in primary or secondary patency of AVFs, compared to historical controls.