The Outcomes of Arteriovenous Fistula Cannulated From Different Direction.

Dongliang Zhang, MD10 enrolled

Overview

The investigators hypothesis that aneurysms and stenoses will be decreased if the direction of inserted arterial needle were same as the direction of blood flow, when compared to the opposite direction puncture.

Native arteriovenous fistula (AVF) is the preferred access for hemodialysis, and cannulation technique is very important factors affect the outcomes of AVF. Rope-ladder cannulation is one kind of the standard puncture techniques which is used commonly in maintenance hemodialysis (MHD) patients. There are many complications for rope-ladder cannulation, such as venous aneurysm and vascular stenosis, which may induce AVF dysfunction. For the venous outflow way, there always be aneurysm followed by stenoses at the sites of needle connected with the arterial line in rope-ladder cannulation patients. The investigators hypothesis that the directions of inserted arterial needles should affect the AVF outcomes. The present prospective study will compare the outcomes of AVF between the puncture direction at arterial needle sites same as blood flow and opposite to blood flow.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

Conditions

Arteriovenous Fistula

Interventions

Same direction cannulationOTHER

The puncture direction of the arterial needle is same as the blood flow in every hemodialysis session.

Opposite direction cannulationOTHER

The puncture direction of the arterial needle is opposite to the blood flow in every hemodialysis session.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: * MHD patients with autogenous AVF. * Newly setup AVF in 3 months. * Fore- or Upper arm AVF. * Flow of \>800ml/min detected by using the ultrasound dilution technique. Exclusion Criteria: * AVF after neoplasty. * Arteriovenous grafts. * Anticipated live time less than one year. * Patients whose concurrent illnesses, disability, or geographical residence would hamper attendance at required study visit.

Locations (1)

Beijing Friedship Hospital

Beijing, Beijing Municipality, China

Outcomes

Primary Outcomes

Prevalence of AVF aneurysm and stenosis.

Compare the prevalence of AVF aneurysm and stenosis between two groups during 12 months.

Time frame: 12 months

Secondary Outcomes

Proportions of AVF dysfunction in different groups.

Compare the proportions of AVF dysfunction between two groups during 12 months.

Time frame: 12 months

The size of venous aneurysm.

Measure the maximum size of venous aneurysm by using ultrasonography at month 12.

Time frame: 12 months

Diameter of venous stenosis.

Measure the minimum diameter of venous stenosis by ultrasonography at month 12.

Time frame: 12 months

Percentages of unsuccessful cannulations.

Unsuccessful cannulations include mis-cannulation, cannulation ease, hematoma, more than once cannulation at arterial site.

Time frame: 12 months

Events of AVF obstruction.

AVF obstruction and the following treatments as central venous catheters and interventions will be recorded and compared between two groups during 12 months.

Time frame: 12 months

Data from ClinicalTrials.gov

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