A one-sheath inverse method in vascular access intervention therapy for hemodialysis patients

Abstract

Introduction: Vascular access intervention therapy (VAIVT) is an essential interventional therapy in the field of hemodialysis therapy that allows for the long-term vascular access functionality to be maintained. The venous approach is often performed in VAIVT for arteriovenous fistula. When lesions are present on the upstream and downstream sides from the approach site, it is likely that two sheaths will be inserted from two facing punctures. However, we have adopted a one-sheath inverse method using a guidewire in such cases.

Case presentation: We herein describe the steps of the technique that we have performed and report the successful treatment of a 77-year-old woman who developed arteriovenous fistula failure.

Discussion: To the best of our knowledge, the concrete and detailed technique has not been reported in the English literature to date. The merit of the technique is that it allows VAIVT to be performed using one sheath with one approach site in cases in which lesions are present on the upstream and downstream sides from the approach site. The other benefits include pain reduction, a shortened operation time, and reduced costs. Because vascular access location is usually superficial, the technique can be utilized with relative ease.

Conclusion: A one-sheath inverse method is useful. We hope that the technique will be more widely recognized, allowing the technique to be applied to more cases.

Keywords: Arteriovenous fistula (AVF); Hemodialysis; One-sheath inverse method; Percutaneous transluminal angioplasty (PTA); Vascular access (VA); Vascular access intervention therapy (VAIVT).