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The Venous Window Needle Guide, a hemodialysis cannulation device for salvage of uncannulatable arteriovenous fistulas  William C. Jennings, MD, Spencer.

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Presentation on theme: "The Venous Window Needle Guide, a hemodialysis cannulation device for salvage of uncannulatable arteriovenous fistulas  William C. Jennings, MD, Spencer."— Presentation transcript:

1 The Venous Window Needle Guide, a hemodialysis cannulation device for salvage of uncannulatable arteriovenous fistulas  William C. Jennings, MD, Spencer W. Galt, MD, Surendra Shenoy, MD, Shouwen Wang, MD, PhD, Eric D. Ladenheim, MD, Marc H. Glickman, MD, Pranay Kathuria, MD, Barry J. Browne, MD  Journal of Vascular Surgery  Volume 60, Issue 4, Pages (October 2014) DOI: /j.jvs Copyright © 2014 The Authors Terms and Conditions

2 Fig 1 a, The Venous Window Needle Guide (VWING; Vital Access Corp, Salt Lake City, Utah). The cannulation device is comprised of a single piece of titanium that allows repeated access of an arteriovenous fistula (AVF) through a single puncture site (buttonhole technique). b, The schematic image shows the VWING sutured to the anterior AVF wall using the eight suture slots. Cannulation is allowed using the buttonhole technique 3 weeks after implantation. c, Each VWING device is 17.7 mm in length and available in 7 and 9 mm widths for variation in vessel diameter. AVF depth variation is accommodated by available 4-, 6-, 8-, and 10-mm heights. All images were provided by and reproduced with permission of Vital Access Corporation. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 The Authors Terms and Conditions

3 Fig 2 The photo shows a Venous Window Needle Guide (VWING; Vital Access Corp, Salt Lake City, Utah) device sutured to the anterior surface of the fistula just before closure of the incision. The anterior surface of the fistula was exposed, however, the vein was otherwise left undisturbed. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 The Authors Terms and Conditions

4 Fig 3 A limited (focal) lipectomy is shown in this photo. The excision of the small segment of adipose tissue was necessary at the proximal Venous Window Needle Guide (VWING; Vital Access Corp, Salt Lake City, Utah) site to ensure easy palpation of the device for reliable cannulation. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 The Authors Terms and Conditions

5 Fig 4 The photo shows an arteriovenous fistula (AVF) 3 weeks after implantation of two Venous Window Needle Guide (VWING; Vital Access Corp, Salt Lake City, Utah) devices at the time of initial cannulations. The arrows indicate the easily palpated cannulation ridges. In most patients, prompt AVF access and conversion to blunt needles was allowed. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 The Authors Terms and Conditions

6 Fig 5 The number and percentage of Venous Window Needle Guide (VWING; Vital Access Corp, Salt Lake City, Utah) devices in use during the 6-month study period. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 The Authors Terms and Conditions

7 Fig 6 The Venous Window Needle Guide (VWING; Vital Access Corp, Salt Lake City, Utah) site-associated and non-VWING site-associated contribution to loss of fistula primary patency are shown in the Kaplan-Meier vascular access patency display. Cumulative (secondary) and assisted patency rates were 100% during the study period. The number of patients at risk for each group is indicated at the bottom of the graph. AVF, Arteriovenous fistula; SAVE, Venous Window Needle Guide for Salvage of AV Fistulae. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 The Authors Terms and Conditions

8 Fig 7 A Venous Window Needle Guide (VWING; Vital Access Corp, Salt Lake City, Utah) buttonhole site after 6 months of regular cannulation is shown (circled). The distal (arterial) site has been cannulated. This typical VWING buttonhole site was small and free of inflammation or edema, likely because of the ease and reliability of cannulation. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2014 The Authors Terms and Conditions

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