percutaneous avf technology -impressions and results from...
TRANSCRIPT
Sylt Bad GriesbachBarmbek (Hamburg) Falkenstein Ini Hannover
Percutaneous AVF technology - Impressions and results from the only physician on the
planet that used both existing systems
Robert Shahverdyan
Head of Vascular Access CenterAsklepios Clinic Barmbek, Hamburg
Percutaneous AVF technology - Impressions and results from both existing systems
No conflict of interests
everlinQ or Ellipsys ?
everlinQ or Ellipsys ?
everlinQTM 4 endoAVF System
Magnetic Coupling
Magnetic Coupling
Square Magnets
for automatic alignment4 Fr Rapid Exchange Catheters
for vessel access and navigation
Rotational Indicators
for easy alignment confirmation Radiofrequency electrode
for endoAVF creation
RF Generator
Ellipsys System
Ellipsys Power Controller
Ellipsys Catheter
Vascu
PTA-Balloon
Hamburg experience with everlinQTM
4F
Patient Characteristics
# of Cases to date 12 (in 2018)
Age (median; range) 64 (32-80)
Gender: male 92% (11/12)
Pre-dialysis patients 42% (5/12)
CVC before endoAVF 50% (6/12)
Diabetes 50% (6/12)
Previous AVF 16,5% (2/12)
Technical success 100%
Procedural/Clinical Outcomes
Regional anesthesia 92% (11/12)
Procedure time (median; range) 75 min (35-150 min)
Amount of contrast medium (median; range) 9 ml (4-19 ml)
Coil-Embolisation of V. brachialis 87,5% (11/12)
AV-anastomosis
- radial-radial / - ulnar-ulnar 92% (11/12) / 8% (1/12)
Access vessels
- radial + radial 84% (10/12)
- brachial + radial 8% (1/12)
- basilic + ulnar 8% (1/12)
Hamburg experience with everlinQTM
4F
EverlinQ at Shuntzentrum AK Barmbek, Hamburg
Hamburg experience with Ellipsys
Patient Characteristics
# of Cases to date 6 (in 2018)
Age (median; range) 63 (40-80)
Gender: male 84% (5/6)
Pre-dialysis patients 33% (2/6)
CVC before endoAVF 50% (3/6)
Diabetes 50% (3/6)
Previous AVF 16.6% (1/6)
Technical success 100%
Hamburg experience with Ellipsys
Procedural/Clinical Outcomes
Regional anesthesia 100% (6/6)
Procedure Time (median; range) 17 min (12-24 min)
Amount of contrast medium 0 ml
Coil-Embolisation of V. brachialis 0%
AV-anastomosis
- radial-perforator 100% (6/6)
PTA-Balloon
- 5x20 mm 66.6% (4/6)
- 4x20 mm 33.3% (2/6)
Ellipsys at Shuntzentrum AK Barmbek, Hamburg
ULTRASOUND MACHINE
(Dis)Advantage?
ONE MORE THING...ONE MORE THING...
Advantages/Disadvantages?
Case demonstration
• 40 y old male, CKD V, terminal
• HD since 2017 via CVC
• AV-Fistula history:
• Cimino-AVF left forearm from 09.2017
• Occlusion on 05.08.2018
Case demonstration
• AV-Fistula history:
• Occlusion of Cimino-AVF 05.08.2018
• Unsuccessful thrombectomy due to complete hyperplasia
• Left EndoAVF (EverlinQ) radial-radial 06.08.2018
• Intraoperative flow 980 ml/min
• Postoperative flow 1200 ml/min
• No dialysis possible on 30.08.2018
Case demonstration
Case demonstration
Case demonstration
Case demonstration
• FU on 12.09.2018
• Dialysis ok
• No CVC
• Functional fistula
• Volume Flow 680 ml/min
• Gratified patient
Posted with patient‘s permission
Conclusions/Recommendations
Thank You
Ärzteakademie
Kompaktkurs
Freitag, 16. November 2018, 09:00 – 15:00 Uhr
Asklepios Klinik Barmbek
Symposium
Samstag, 17. November 2018, 09:00 – 16:00 Uhr
Asklepios Klinik Barmbek
1. Hamburger Dialyseshunt-Symposium
Kompaktkurs Shuntsonographie und Demerskatheter-Anlage
1. Hamburg VAS, November 17th 2018