Endovascular arteriovenous fistula: Outcomes and comparison with surgical arteriovenous fistula: An updated systematic review and meta-analysis.
Nada K Ameen, Amjad I Albadawi, Shatha K Alghamdi et al.
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In 30 seconds
This systematic review and meta-analysis assessed clinical outcomes after endovascular arteriovenous fistula (eAVF) creation for hemodialysis access and compared eAVF with surgical AVF (sAVF). It included 28 studies: 20 single-arm eAVF studies and 8 comparative studies. Pooled eAVF technical success was 97%, and maturation was 77%; primary patency was 64% at 6 months and 77% at 12 months. Comparative studies found no statistically significant differences in maturation or primary patency, while eAVF showed numerically higher reintervention and lower complication rates.
Key findings
- Pooled technical success for eAVF was 97%, with a maturation rate of 77%.
- Primary patency after eAVF was 64% at 6 months and 77% at 12 months.
- The pooled overall complication rate was 9%, with moderate to high heterogeneity for several outcomes.
- Comparative studies found no statistically significant differences in maturation or primary patency; eAVF had numerically higher reintervention and lower complication rates.
Why it matters
The findings provide an overview of eAVF performance and its comparison with surgical access, including technical success, maturation, patency, and complications. The absence of statistically significant differences in key comparative outcomes is relevant when considering eAVF as an access option, but heterogeneity and numerical differences in reintervention underscore uncertainty in the evidence.
What to keep in mind
The evidence included only 8 comparative studies, and moderate to high heterogeneity was observed across several outcomes.