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Cited by 19Central Venous Catheters and HemodialysisVascular Procedures and ComplicationsVascular Malformations Diagnosis and Treatment

Multiple single cannulation technique of arteriovenous fistula: a randomized controlled trial

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Peralta, Ricardo, Fazendeiro Matos, João, Pinto, Bruno, Gonçalves, Pedro, Sousa, Rui, Felix, Carla, Carvalho, Helena, Vinhas, José +1 more·2022·Hemodialysis International
DOI 10.1111/hdi.12962PMC PMC9291570
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Abstract

Introduction: Despite the impact needling has had on vascular access survival and patient outcome, there is no universal or standardized method proposed for proper cannulation. Rigorous studies are needed, examining cannulation practices, and challenges to achieving complication‐free cannulation. Methods: This randomized, open‐label trial was conducted at 18 dialysis units owned by a large private dialysis provider operating in Portugal. Eligible patients were adults on chronic hemodialysis, with a new arteriovenous fistula (AVF); cannulated for at least 4 weeks complication‐free. Patients were randomly assigned in a 1:1 ratio to one of three cannulation techniques (CT): Multiple Single cannulation Technique (MuST), rope‐ladder (RLC), and buttonhole (BHC). The primary endpoint was AVF primary patency at 1 year. Findings: One hundred seventy‐two patients were enrolled between March 2014 and March 2017. Fifty‐nine patients were allocated to MuST, 56 to RLC, and 57 to BHC. MuST and RLC were associated with a better AVF primary patency than BHC. Primary patency at 12 months was 76.3% in MuST, 59.6% in BHC, and 76.8% in RLC group. Mean AVF survival times were 10.5 months (95% CI = 9.6, 11.3) in the MuST group, 10.4 months (95% CI = 9.5, 11.2) in RLC, and 9.5 months (95% CI = 8.6, 10.4) in BHC. BHC was a significant risk predictor for AVF survival with 2.13 times more events than the other two CT (HR 2.13; 95% CI = 1.07, 4.21; p = 0.03). Discussion: MuST was easy to implement without a diagram and there is no need to use blunt needles. This study showed MuST was efficacious and safe in maintaining the longevity of AVF in dialysis patients.

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Cited by

Sorted by citations

Authors
Peralta, R., Fazendeiro Matos, J., Pinto, B., Gonçalves, P., Sousa, R., Felix, C., Carvalho, H., Vinhas, J., & Ponce, P.
Affiliations
  • Fresenius Medical Care Portugal (Portugal) (PT)
  • NephroCare Portugal Fresenius Medical Care Portugal Maia Porto Portugal
  • Iscte – Instituto Universitário de Lisboa (PT)
  • Hospital de São Bernardo (PT)
Corresponding author
Peralta, Ricardo
ORCID
Venue
Hemodialysis International
Publisher
Wiley
Published
2021-07-06
Volume
26
Issue
1
Pages
4-12
ISSN
  • 1492-7535 (ISSN-L)
  • 1542-4758
DOI
10.1111/hdi.12962
PMC
PMC9291570
OpenAlex
W3178943637
Cited by
19
References
0
Citations by year
2026: 4 · 2025: 5 · 2024: 3 · 2023: 1 · 2022: 4 · 2021: 2
FWCI
3.06
Type
journal article
Language
en
Open access
Licence
Locations
  • Hemodialysis International (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Repositório do ISCTE-IUL (submittedVersion, other-oa)
Topics
  • Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vascular Procedures and Complications
  • Health Sciences › Medicine › Neurology › Vascular Malformations Diagnosis and Treatment
Keywords
arteriovenous fistula, cannulation technique, buttonhole cannulation, hemodialysis vascular access, maintenance hemodialysis
MeSH terms
Adult, Arteriovenous Fistula, Arteriovenous Shunt, Surgical, Catheterization, Renal Dialysis, Humans

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