Nav: Home

New magnet technology creates easy blood access for hemodialysis patients

June 14, 2017

(Wednesday, June 14, 2017 -- Toronto) A new, minimally invasive system which uses radiofrequency energy instead of open surgery to create access for patients needing hemodialysis is reliable, with minimal complications, according to data published in the American Journal of Kidney Disease.

For hemodialysis patients, creating direct access to their blood is critical because they need to have their blood cleaned regularly by a dialysis machine.

A single-arm, prospective study of 80 predialysis and dialysis patients from nine centres in Canada, Australia and New Zealand for one year showed that an arteriovenous fistula (AV-fistula) - the recommended type of vascular access for patients to connect to a hemodialysis machine - was created successfully in 98% of all cases, with 87% being physiologically suitable for dialysis within three months of creation by this new magnet-based endovascular technology.

Regarding complications, 1.8% of AV-fistulas had thrombosis or clots within three months and 10.5% within 12 months - lower than that reported in current AV-fistulas created by open surgery. Studies have reported that from 14-26% of traditional fistulas had clots within 12 months.

Traditional surgical fistulas often need two to three additional procedures before the AV-fistula is ready for use, while the AV-fistulas created by this new technology needed fewer.

The study, entitled, "Endovascular Proximal Forearm Arteriovenous Fistula for Hemodialysis Access: Results of the prospective, multicenter Novel Endovascular Access Trial (NEAT)," is published online in the American Journal of Kidney Disease, June 14, 2017. Dr. Charmaine Lok, Medical Director of both the Chronic Kidney Diseases and Hemodialysis Programs at the Toronto General Hospital, University Health Network is an internationally renowned specialist on hemodialysis access and the principal investigator of the trial.

"Chronic kidney patients currently do not have a minimally invasive option for creating AV-fistulas and yet it could reduce a significant barrier for patients to have an AV-fistula, which is the preferred access for hemodialysis. Patients often refuse AV-fistula creation because they do not want to undergo open surgery, and this technology can provide another option for patients," says Dr. Lok, who is also a senior scientist at Toronto General Hospital Research Institute.

She notes that the use of AV-fistulas remains low in many regions world-wide. She adds that traditional surgical AV-fistulas can require long wait times, general anesthesia, and pre-operative assessments.

Currently, an AV-fistula is made through a surgical incision in the arm to expose and access the artery and vein, which are then cut and stitched together. The vein grows bigger and stronger (now called an AV-fistula) over six to 12 weeks. The strengthened AV-fistula, which can sometimes last for decades, can then be used for regular hemodialysis treatments.

In contrast to the usual surgical option, the NEAT clinical study examined a new technique to create an AV-fistula without open surgery. Using the everlinQ endoAVF System by TVA Medical, flexible magnetic catheters were inserted into an artery and a vein in the arm of each participating patient. The vessels were drawn together by the magnets. A small burst of radiofrequency energy, given through the catheters, was then used to create a connection between the artery and vein, creating the AV-fistula. The catheters were then removed leaving no surgical scar. These study procedures were performed on outpatients who did not need general anesthesia.

Dr. Dheeraj Rajan, the co-primary investigator in the study and Vascular/Interventional Radiologist at University Health Network's Joint Department of Medical Imaging, supervised the interventional procedure for all Toronto General Hospital and other study centre patients.

"This novel technology is a substantial benefit to our hemodialysis patients," he says, "we can now access veins and arteries that otherwise would not be easily accessible via surgery, and we can do this in a safe, quick way that is easy for our patents to tolerate."
-end-
The everlinQ endoAVF System is approved for use in Canada and Europe.

The Novel Endovascular Access Trial (NEAT) was supported by a personnel award from the Heart and Stroke Foundation and TVA Medical. Dr. Rajan is an equity stock owner of TVA Medical.

About Toronto General Hospital

Toronto General Hospital is a partner in University Health Network, along with Toronto Western, the Princess Margaret Cancer Centre, the Toronto Rehabilitation Institute and the Michener Institute for Education. The scope of research and complexity of cases at Toronto General Hospital have made it a national and international source for discovery, education and patient care. It has one of the largest hospital-based research programs in Canada, with major research in cardiology, transplantation, diabetes, regenerative medicine, infectious diseases, genomic medicine, psychosocial care and health systems. Toronto General Hospital is a research and teaching hospital affiliated with the University of Toronto. http://www.uhn.ca

University Health Network

Related Kidney Disease Articles:

Combating chronic kidney disease with exercise
A University of Delaware research team is combating chronic kidney disease (CKD) with exercise.
A new mutation in kidney disease
Osaka University researchers find an unexpected mutation in proteins of the exosome could be a valuable biomarker for diagnosing the risk of kidney disease.
New answers for kids with inherited kidney disease
A new gene behind a rare form of inherited childhood kidney disease has been identified by a global research team.
Revealed: The biochemical pathways of kidney disease
In a study, recently published in PLOS Genetics, Chiara Gamberi and her coauthors developed an innovative fruit fly-based model of the types of harmful cysts that can form on kidneys.
Forging new defenses against diabetic kidney disease
Scientists at Joslin Diabetes Center have revealed an unexpected route to slow the progression of diabetic kidney disease, targeting a biological pathway that is the main channel for the metabolism of glucose in the cell.
Kidney disease is a major cause of cardiovascular deaths
In 2013, reduced kidney function was associated with 4 percent of deaths worldwide, or 2.2 million deaths.
A kidney disease's genetic clues are uncovered
Researchers at Columbia University Medical Center have identified genes that are linked to the underlying molecular defect in people with IgA nephropathy, an autoimmune kidney disease.
Beating kidney disease together
Chronic kidney disease is a frequently encountered disorder: more than 10% of the population suffer from such problems.
Reflux and ulcer medications linked to kidney stones and chronic kidney disease
Individuals who took proton pump inhibitors or histamine receptor-2 blockers for heartburn, acid reflux, or ulcers had elevated risks of developing kidney stones.
Method to create kidney organoids from patient cells provides insights on kidney disease
Scientists have developed a method to coax human pluripotent stem cells to mature into cells that go on to form the functional units of the kidney.

Related Kidney Disease Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#529 Do You Really Want to Find Out Who's Your Daddy?
At least some of you by now have probably spit into a tube and mailed it off to find out who your closest relatives are, where you might be from, and what terrible diseases might await you. But what exactly did you find out? And what did you give away? In this live panel at Awesome Con we bring in science writer Tina Saey to talk about all her DNA testing, and bioethicist Debra Mathews, to determine whether Tina should have done it at all. Related links: What FamilyTreeDNA sharing genetic data with police means for you Crime solvers embraced...