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Episode 77

Endovascular AV Fistula Creation

with Dr. Neghae Mawla and Dr. Christopher Beck

BackTable, LLC (Producer). (2020, August 17). Ep. 77 – Endovascular AV Fistula Creation [Audio podcast]. Retrieved from https://www.backtable.com/podcasts

Interventional Nephrologist Neghae Mawla from Dallas Nephrology Associates walks us through his experiences with endovascular AV Fistula creation, including devices, patient prep, procedure steps and post procedure care.

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Podcast Participants

Dr. Neghae Mawla

Dr. Neghae Mawla is an Interventional Nephrologist with Dallas Nephrology Associates in Texas.

Dr. Christopher Beck

Host Dr. Chris Beck is a practicing interventional radiologist with Regional Radiology Group in New Orleans.

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Show Notes

1. Guest Introduction
a. Discuss background/training
b. Talk about current practice

2. 10,000 foot discussion regarding dialysis
a. Need for fistula creation
b. Compare to surgical creation

3. Candidates
a. Preprocedural evaluation
b. Specifics regarding AVF creation and vein mapping
c. Who is not a candidate
d. Who is an ideal candidate
e. Referral patterns

4. Preprocedural preparation
a. ASA? Plavix?
b. Anesthesia needs?
c. Nerve blocks

5. Procedure
a. Mightmake sense to talk about different systems first
b. Brief step by step guide
c. Discuss level of difficulty
d. Additional steps after AVF creation

6. Discuss AVF creation in setting of basilic vein transposition
a. Way to collaborate with vascular surgery

7. Postproceduralcare
a. Same day discharge
b. Most feared complicationc.Most common complications

8. Follow up
a. Clinic visits
b. Fistula characteristics
c. When is the fistula ready
d. Discuss what to do next if fistula is not ready for canalization

9. Discuss data
a. Papers you recommend for preparing for this procedure
b. Pivotal Trial
c. Neat Trial

10. Miscellaneous
a. How time consuming is this, from vein mapping to procedure
b. How long does procedure take
c. How does this tie in to conventional dialysis practice
d. Are they more difficult to stick? Have you seenresistance with dialysis units accessing these fistulae?


Hull JE, Jennings WC, Cooper RI, Waheed U, Schaefer ME, Narayan R. The Pivotal Multicenter Trial of Ultrasound-Guided Percutaneous Arteriovenous Fistula Creation for Hemodialysis Access.J Vasc Interv Radiol. 2018;29(2):149-158.e5. doi:10.1016/j.jvir.2017.10.015. https://avenumedical.com/wp-content/uploads/2018/03/avenu-us-pivotal-trial-jvir-feb-2018.pdf

Lok CE, Rajan DK, Clement J, et al. Endovascular Proximal Forearm Arteriovenous Fistula for Hemodialysis Access: Results of the Prospective, Multicenter Novel Endovascular Access Trial (NEAT).Am J Kidney Dis. 2017;70(4):486-497. doi:10.1053/j.ajkd.2017.03.026. https://www.ajkd.org/article/S0272-6386(17)30692-3/fulltext

Vascupedia Videos:
1. https://vascupedia.com/video/everlinq-4-endoavf-system-taped-case-linc-2018/?pid=1432
2. https://vascupedia.com/presentation/surgical-versus-percutaneous-arteriovenous-fistula-pavf-its-all-about-hemodynamics/
3. https://vascupedia.com/presentation/real-world-experience-nephrologists-opinion-on-pavfs/

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