Abstract
Dialysis treatment for chronic kidney disease was first developed by Dr. Willem Kolff
in 1943, and its availability began to grow in 1962 after which it has become a mainstay
treatment for patients with chronic kidney disease. It is estimated that, in 2021,
15% of adults in the United States (∼37 million people) have chronic kidney disease,
of which 661,000 individuals have renal failure, and 468,000 individuals require dialysis.
There have been several advancements in dialysis treatment since its advent, most
notably the creation of arteriovenous fistulas (AVFs) for venous access in 1966. In
recent years, the U.S. Food and Drug Administration approved two new devices for AVF
creation using a percutaneous approach. These are the WavelinQ (Becton Dickinson,
New Jersey) and the Ellipsys (Avenu Medical, California) endovascular AVF (endoAVF)
devices that use radiofrequency and thermal technologies, respectively, to create
the AVF. Since the introduction of these technologies, several studies have shown
that they are safe and effective, with favorable durability and low rate of serious
adverse events. In this article, we will discuss these two devices and the techniques
used for percutaneous creation of dialysis AVF as an alternative to traditional open
surgical techniques.
Keywords
percutaneous endovascular dialysis access - arteriovenous fistula creation - vascular
access - dialysis - interventional radiology
