When kidney function is impaired and dialysis is needed to clear waste from the body, a stable, long-lasting dialysis access is the key to success. This access (the dialysis vessel) is like a lifeline: it lets blood flow smoothly out of the body, be cleaned by the dialysis machine, and return to the body.
Medicine is constantly searching for more effective and more durable ways to create vascular access. This study takes an in-depth look at the effect of a device used during surgery: the VasQ external support device.
What is VasQ? (not yet imported or used in Taiwan)
The VasQ external support device is a medical device. Many newly created arteriovenous fistulas “fail to mature” or “fail early”, so they cannot be used successfully for dialysis. VasQ was designed to address these problems. It is a thin, strong metal mesh (made of nitinol) that is placed around the junction of the artery and vein during fistula surgery. The device sits outside the vessel and is not placed inside it, so it never contacts the blood; its risk of thrombosis is therefore markedly lower than that of a conventional vascular stent. VasQ aims to improve the success rate and long-term function of arteriovenous fistulas in hemodialysis patients, thereby providing a more reliable and durable dialysis access.
refernce: Endovascular Today :Laminate Medical’s VasQ External Support for AVF Creation Cleared by FDA
reference : Laminate Medical Technologies channel
Academic research
This study was published in July 2025 in the Journal of Vascular Surgery and compared clinical outcomes with and without VasQ. It collected data from 394 kidney patients who needed dialysis between 2017 and 2024. The aim was to examine whether VasQ optimizes dialysis access performance by comparing the “surgical group that used VasQ” with the “surgical group that did not”.
The two approaches were the “without VasQ: anatomical snuffbox arteriovenous fistula” (SB-AVF) and the “with VasQ: radiocephalic arteriovenous fistula” (ES-RCAVF). In short, the former is the conventional surgical approach, while the latter adds the VasQ device to help the dialysis vessel develop.
The researchers looked at several key indicators, such as:
- Maturation rate: after surgery, the access needs a period of development to reach enough diameter and strength to withstand needling during dialysis.
- Successful cannulation rate: once the access has matured, whether nurses can insert the dialysis needles smoothly.
- Catheter removal rate: some patients need a temporary dialysis catheter before the access matures. If the access is good, the catheter can be removed earlier.
- Stenosis rate: whether the dialysis access is prone to narrowing, which impairs blood flow.
- Patency rate: how long the dialysis access stays functional so that dialysis can proceed smoothly.
- Reintervention rate: how many additional procedures or treatments are needed to repair the access after it fails or develops problems.
The results showed that the ES-RCAVF with the VasQ device performed better in some respects:
- Better short-term results: the proportion of ES-RCAVF accesses that matured within four weeks rose significantly to 81.9%, compared with only 69.7% for the conventional SB-AVF. This indicates that accesses with the VasQ device can be ready for dialysis more quickly.
- Easier to use: the successful cannulation rate of ES-RCAVF was also higher, at 82.6% versus 71.6% for the conventional method, meaning nurses could find the vessel and cannulate it successfully more easily.
- Faster removal of temporary catheters: although the difference was not statistically significant, a slightly higher proportion of patients with VasQ had their temporary dialysis catheter removed within 6 months.
However, for some long-term indicators the two approaches did not differ much:
- Vessel stenosis and long-term patency: neither the proportion of stenosis near the anastomosis (close to the surgical connection) nor the patency over five years (whether fully patent, patent after simple intervention, or patent after more extensive intervention) differed significantly between the two approaches.
- Maintenance needs: the average number of maintenance or repair procedures per year was also similar for both accesses.
The study also highlighted factors that influence access success:
- VasQ device: the device does help improve access maturation and the successful cannulation rate, and allows patients to be freed from temporary catheters sooner.
- Sex and diabetes: women and patients with diabetes may have a lower chance of early access maturation. Women may also face a lower rate of temporary catheter removal and a higher risk of vessel stenosis.
- Age: the older the patient, the lower the chance of early access maturation and of temporary catheter removal may be.
| Characteristics | SB-AVF (anatomical snuffbox AV fistula) | ES-RCAVF (AV fistula with VasQ external support) | Statistical significance (P value) |
| 4-week maturation rate | 69.7% | 81.9% | 0.009 |
| Successful cannulation rate (6 months) | 71.6% | 82.6% | 0.044 |
| Dialysis catheter removal rate (6 months) | 56.9% | 62.9% | 0.28 |
| 5-year primary patency | 26.1% | 26.6% | 0.531 |
| 5-year assisted primary patency | 51.2% | 52.4% | 0.778 |
| 5-year secondary patency | 56.5% | 57.8% | 0.1278 |
The study suggests that for most patients who need dialysis access treatment, the ES-RCAVF approach with the VasQ device promotes faster access maturation and easier use in the short term. For certain patients, however, such as young people without diabetes, the conventional SB-AVF remains a viable option because it preserves the distal wrist vessels and leaves more options if a new access is needed in the future. By providing these data, the study aims to help clinicians judge more effectively which dialysis access procedure best suits each patient.
NCECU
