Study Compares Surgical AVF Creation and a New Endovascular Approach

September 20, 2016—Charmaine E. Lok, MD, presented findings from a study comparing postcreation interventions between patients undergoing surgical arteriovenous fistula (SAVF) creation and a new endovascular AVF creation during the second Late-Breaking Trials session at VIVA 16, the 14th annual Vascular InterVentional Advances meeting, which is sponsored by VIVA Physicians, Inc. and held September 18–22, 2016 at the Wynn Las Vegas in Las Vegas, Nevada.

Dr. Lok noted that AVFs are the guideline­-recommended hemodialysis vascular access. However, SAVFs are challenged by high failure rates, and postcreation interventions are often required to facilitate maturation and maintain function. 

In this study, Medicare Standard Analytical Files were used to determine patient demographic and clinical characteristics and identify and determine rates of postcreation interventions in patients with SAVFs created from 2011 to 2013. Rates of postcreation interventions per patient-year were determined based on patients’ outpatient and physician claims during specified follow­-up.

Demographics and clinical information for patients with endovascular AVFs were obtained from the single­-arm Novel Endovascular Access Trial (NEAT) performed in Canada, Australia, and New Zealand. The technology used is not available in the United States and is pending US Food and Drug Administration review. Propensity score analysis was used to match key demographic and clinical characteristics between Medicare and NEAT patients (n = 60) in a 1:1 ratio.

In this propensity­ score–matched comparison, patients with endovascular AVFs required fewer postcreation interventions and had fewer health care costs than patients treated with SAVF, concluded Dr. Lok at VIVA 16.