Updated Practice Guidelines for Percutaneous Arteriovenous Fistulas in Dialysis Access

The Society of Interventional Radiology (SIR) has published comprehensive new practice guidelines for creating percutaneous arteriovenous fistulas (pAVFs) aimed at improving dialysis access. These guidelines, released online in the Journal of Vascular and Interventional Radiology (JVIR), provide vital recommendations on developing and managing pAVF programs, including patient preparation, procedural techniques, complication management, and follow-up care.

End-stage renal disease (ESRD) continues to pose significant health challenges worldwide, with hemodialysis being a primary treatment. A well-constructed durable fistula reduces patient morbidity and enhances quality of life. Interventional radiologists play a critical role in the long-term care of dialysis patients, and these guidelines reinforce their importance as key members of the multidisciplinary team.

This update marks nearly six years since the FDA cleared the procedure for widespread clinical use. The guidelines aim to enable interventional physicians to employ evidence-based approaches, thus improving patient outcomes and promoting the use of pAVFs as a reliable, long-lasting dialysis access option.

Dr. Robert A. Lookstein, SIR President, emphasized that the guidelines highlight the vital role interventional radiologists serve in the care continuum for dialysis patients. Adhering to these protocols can significantly enhance procedural success rates, minimize complications, and optimize patient quality of life. The document serves as an essential resource for clinicians seeking to incorporate best practices into their pAVF programs.

For more detailed information, the guidelines are available in the Journal of Vascular and Interventional Radiology (2025), and the article is accessible through the DOI: 10.1016/j.jvir.2025.08.019.

Source: https://medicalxpress.com/news/2025-09-guidance-percutaneous-arteriovenous-fistulas-dialysis.html