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Cited by 26Central Venous Catheters and HemodialysisVascular Procedures and ComplicationsRenal and Vascular Pathologies

Cannulation technique and complications in arteriovenous fistulas: a Swedish Renal Registry-based cohort study

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Staaf, Karin, Fernström, Anders, Uhlin, Fredrik·2021·BMC Nephrology
DOI 10.1186/s12882-021-02458-zPMC PMC8265150
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Abstract

Background: The four cannulation techniques, rope ladder (RL), area puncture (AP), buttonhole with blunt needles (BHb), and buttonhole with sharp needles (BHs), affects the arteriovenous fistula (AVF) in different ways. The aim of this study was to describe the relationship between the different cannulation techniques and the occurrence of AVF complications. Methods: The study was performed as a national registry-based cohort study using data from the Swedish Renal Registry (SRR). Data were collected from January 2014 to October 2019. Seventy of Sweden’s dialysis units participate in the registry. We analyzed a total of 1328 AVFs in this study. The risk of complications was compared between the four different cannulation techniques. The risk of AVF complications was measured by the incidence and incidence rate ratio (IRR). We compared the IRRs of complications between different cannulation techniques. Results: BHs is the most common cannulation technique in Sweden. It has been used in 55% of the AVFs at some point during their functional patency. BHb (29%), RL (13%), and AP (3%) has been used less. BHb had the lowest risk of complications compared to the other techniques, and a significantly lower risk of stenosis, infiltration, cannulation difficulties, compared to RL and BHs. Cannulation difficulties were significantly more common using AP compared to BHs, and BHb. Infections were not significantly increased using the buttonhole technique. Conclusions: BHb had the lowest risk of complications. Infections were not significantly increased using the buttonhole technique. Dialysis units with a low infection rate may continue to use the buttonhole technique, as the risk of complications is lower.

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  • Increasing evidence indicates that nursing techniques significantly influence the lifespan of vascular access.

    “Increasing evidence indicates that nursing techniques significantly influence the lifespan of vascular access (3–5).”

    From Construction of nursing-sensitive quality indicators for hemodialysis vascular access: a Delphi study (2026) · cites this paper as [3]

    The Introduction (page unavailable) says daily care, cannulation technique, and needle placement affect arteriovenous fistulas; the Discussion says cannulation techniques affect complication risk. The study examines fistula complications, however, and does not establish a significant effect of nursing techniques on the lifespan of vascular access generally. (LLM, conf=0.83)

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Cited by

Sorted by citations

Authors
Staaf, K., Fernström, A., & Uhlin, F.
Affiliations
Linköping University (SE)
Corresponding author
Staaf, Karin
ORCID
Venue
BMC Nephrology
Publisher
Springer Science and Business Media LLC
Published
2021-07-07
Volume
22
Issue
1
Pages
256-256
ISSN
1471-2369 (ISSN-L)
DOI
10.1186/s12882-021-02458-z
PMC
PMC8265150
OpenAlex
W3179776036
Cited by
26
References
0
Citations by year
2026: 2 · 2025: 6 · 2024: 5 · 2023: 4 · 2022: 9
FWCI
5.50
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Nephrology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DiVA (Linkoping University) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Linköping University
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 › Pulmonary and Respiratory Medicine › Renal and Vascular Pathologies
Keywords
arteriovenous fistula, cannulation technique, buttonhole cannulation, vascular access complications, fistula stenosis, cannulation difficulty, catheter-related infection, hemodialysis vascular access, end-stage renal disease
MeSH terms
Arteriovenous Shunt, Surgical, Humans, Infections, Registries, Risk Factors, Sweden

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