The arteriovenous fistula (AVF) is the dialysis lifeline for many patients. In May 2025 the Journal of Vascular Surgery (JVS) published a US retrospective study comparing results when fistulas are created and followed up in different settings. This digest summarizes the main points for patients and clinicians.
What did the study compare?
The study reviewed nearly 400 patients, grouped by where surgery and follow-up took place: a conventional hospital (surgery and follow-up both at a hospital), a mixed group (surgery at a conventional hospital, follow-up at an outpatient surgical vascular center), and an outpatient surgical vascular center (surgery and follow-up both there). An outpatient surgical vascular center is usually an outpatient unit focused on dialysis access surgery and care, where patients complete surgery and follow-up without being admitted.
Results
Surgical complication rate
- Conventional hospital: 6.4%
- Mixed group and outpatient surgical vascular center: 1.6%
Fistula maturation rate
- Conventional hospital: 54%
- Mixed group: 86%
- Outpatient surgical vascular center: 93%
Time from surgery until the fistula could be used
- Conventional hospital: about 98 days
- Mixed group: 66 days
- Outpatient surgical vascular center: 52 days
Points to keep in mind
- This is a retrospective study; patients were not randomized, and vessel condition, comorbidities and follow-up may have differed between groups.
- The study was done in the US health system, and results may not apply in Taiwan.
- The figures are group averages and do not predict any individual patient’s result.
- The choice of where to have surgery and follow-up depends on the patient’s vessels, comorbidities and access to care; please discuss it with your nephrologist and vascular surgeon.
Source: Journal of Vascular Surgery, May 2025
https://www.jvascsurg.org/article/S0741-5214(25)00020-5/fulltext
This journal digest is general education information and does not replace a doctor’s diagnosis or treatment. It makes no comparison between facilities and is not a guarantee of results.
