Comparing Two Surgical Methods for Creating Arteriovenous Fistulas in Adults with Advanced Chronic Kidney Disease Needing Hemodialysis

What this Trial Is About

Researchers are comparing two surgical methods for creating arteriovenous fistulas AVFs, which are needed for hemodialysis in people with advanced chronic kidney disease CKD. AVFs are preferred because they last longer and have fewer complications than other access types, but many fail to mature properly. This study evaluates the traditional End-to-Side ETS technique against a newer Piggyback Straight Line Onlay Technique pSLOT to see if pSLOT can reduce issues like narrowing, clotting, and failure. Participants are randomly assigned during surgery to receive either the ETS or pSLOT method under local or regional anesthesia. The trial involves two groups one receiving the terminolateral anastomotic ETS technique and the other the piggyback anastomotic pSLOT technique. Follow-up visits occur at 1 month and 12 months after surgery to assess fistula maturation, blood flow, patency, and usability for dialysis. Remote follow-ups are allowed if needed. Participants undergo clinical exams and ultrasound mapping before surgery to ensure they meet anatomical requirements. During follow-ups, ultrasound and clinical assessments measure fistula development and function. Researchers will track outcomes like stenosis, thrombosis, reinterventions, blood flow, surgery and maturation times, and wound complications. The study requires informed consent, follows ethical standards, and keeps data confidential. Total participation spans at least 12 months with regular monitoring.

Creation of Arteriovenous Fistulas for Hemodialysis Using the End-to-side Anastomotic Technique vs. Piggyback.