Interventionalists
The following are some specific things interventionalists (interventional radiologists and interventional nephrologists) can do to improve AV fistula care. These are actions that you can take immediately; they will require cooperation between and, perhaps, changes in practice of, all providers in the system.
- Know the rates of AV fistula prevalence and incidence for your patients.
- Review the recommended strategies from the Fistula First Change Package and choose those that make the most sense for your practice.
Consider getting started with these changes:
Change Concept 3 - Early Referral to surgeon for "AVF Only" Evaluation and Timely Placement
Change Concept 9 - Monitoring and Maintenance to Ensure Adequate Access Function
Change Concept 10 - Education for Caregivers and Patients
Change Concept 11 - Outcomes Feedback to Guide Practice
Educational Materials
The following articles, tools, and slide programs are designed for interventionalists to improve AV fistula care.
Interventional Nephrology: From Episodic to Coordinated Vascular Access Care
Tunneled Jugular Small-Bore Central Catheters as an Alternative to Peripherally Inserted Central Catheters for Intermediate-term Venous Access in Patients with Hemodialysis and Chronic Renal Insufficiency
Management of Cephalic Arch Stenosis
Video: Woggle Technique - Created by Dr. Scott Trerotola in 2008
Video: Purse-String Sutures - Created by Dr. Jeffrey Hoggard in 2008
Interventionalist Education and Resources Outline
Pre-Access Mapping Flow Chart
Interventional Radiology in Fistulae Video Series
This series of brief videos covers the range of percutaneous interventions in hemodialysis fistulae. These videos were produced in 2007 by Dr. Scott Trerotola and the Medical Media group of the University of Pennsylvania Medical Center’s Department of Radiology.
Interventional Radiology in Fistulae: Introduction
Interventional Radiology in Fistulae: Fistulography
Interventional Radiology in Fistulae: Screening
Interventional Radiology in Fistulae: PTA
Interventional Radiology in Fistulae: Stents
Interventional Radiology in Fistulae: Declotting
Interventional Radiology in Fistulae: Salvaging Immature Fistulae
Interventional Radiology in Fistulae: Conclusions