515 - Single Center Comparison of Endovascular and Surgical Arteriovenous Fistula Creation for Hemodialysis Access

Monday, April 13, 2026

12:10 PM - 1:10 PM ET

Poster Presenter(s)

Amber Lamberty, BS (she/her/hers)

Medical student
University of Illinois College of Medicine - Chicago, United States

Author/Co-author(s)

Wali Badar, MD

Resident physician
University of Illinois at Chicago, United States
JB

James T. Bui, MD, FSIR

Professor of Radiology & Medicine
University of Illinois Hospital, United States
RG

Ron C. Gaba, MD, MS

Professor
University of Illinois at Chicago, United States

Purpose: This study compared clinical outcomes after endovascular arteriovenous fistula (endo AVF) creation versus surgically created AVF (surgical AVF) at a single institution.

Materials and Methods: In this retrospective, single center study, electronic medical records were reviewed for consecutive patients referred for endo AVF and surgical AVF creation between January 2019 and November 2024. Data collected included patient demographics, endo AVF and surgical AVF technical outcomes, hemodialysis (HD) treatment outcomes, patency outcomes, and adverse events (AEs).

Results: The endo AVF cohort consisted of 57 patients (M:F=35/22, 61% men, 39% women; mean age 57 years) with end-stage renal disease (ESRD) (n=36, 63%) or chronic kidney disease (CKD) (n=21, 37%) who underwent technically successful endo AVF creation. In the surgical AVF cohort, there were 46 patients (M:F=20/26, 43% men, 57% women; mean age 60 years) with ESRD (n=35, 76%) or CKD (n=11, 24%). Time from referral to creation was shorter in the endo AVF cohort, but not statistically different (48±33 vs. 75±117 days, P=0.111). AE rate was similar (18/57, 32% vs. 11/46, 24%, P=0.390). Endo AVFs required a higher number of interventions to achieve maturation (0.9±1.2 vs 0.4±0.8, P= 0.012) and frequently (40/57, 70%) required brachial vein embolization to mitigate competing outflow. A total of 36 endo AVFs and 21 surgical AVFs matured at 81±66 and 112±106 days, respectively; maturation time was not different (P=0.121). 48 endo AVF and 42 surgical AVF patients required HD initiation during the study period and more endo AVF patients were able to initiate dialysis via their fistula compared to surgical AVF patients (35/48, 73% vs. 20/42, 48%; P=0.018). A higher proportion of endo AVF subjects achieved HD catheter removal after fistula creation (29/46, 63% vs. 16/41, 39%; P=0.025). Median primary patency was longer in the endo AVF cohort but not statistically different (1.7 years, CI: 0.8-1.8 vs. 0.5 years, CI: 0.3-1.2 years; P=0.276).

Conclusion: Endo AVFs can be created with high technical success and readily allow for the initiation of HD. However, they may require more interventions for assisted maturation compared to surgical AVFs. For patients on catheter HD, endo AVF creation may facilitate earlier catheter removal.