#United States #Fairfax #Interventional Radiology #dialysis access #pAVF

New Guidelines on Percutaneous Arteriovenous Fistulas (pAVF)

On September 9, 2025, the Society of Interventional Radiology (SIR) officially launched innovative practice guidelines aimed at enhancing the creation and management of percutaneous arteriovenous fistulas (pAVFs) for patients requiring dialysis access. This significant development, published in the Journal of Vascular and Interventional Radiology, addresses the critical need for effective hemodialysis methods amidst the rising prevalence of end-stage renal disease (ESRD) worldwide.

Importance of pAVFs in Dialysis Access

As noted by SIR President Dr. Robert A. Lookstein, the importance of a durable hemodialysis access fistula is twofold: it not only minimizes associated morbidity but also substantially uplifts the quality of life for ESRD patients. Developing and sustaining a pAVF program is integral to the longitudinal care of dialysis patients, and the new guidelines are a step towards reinforcing the role of interventional radiologists (IRs) in this domain.

An Overview of the Guidelines

The recently published guidelines serve as a comprehensive roadmap for practitioners. They delineate essential components for establishing a pAVF program, including:

• - Patient Preparation: Engaging patients before the procedure ensures they understand the process, risks, and benefits.
• - Procedure Performance: Best practices for conducting the pAVF procedure are outlined to enhance its overall success rate.
• - Complication Management: Recognizing potential complications and having clear protocols in place can mitigate risks.
• - Follow-Up Care: Continuous patient monitoring is pivotal for long-term success and adjustment of care as necessary.

This update arrives nearly six years post-FDA clearance of the pAVF procedure. Its integration into many clinical frameworks signifies a growing acknowledgment of its value as a sustainable method for functional dialysis access.

Enhancing Patient Care Through Evidence-Based Approaches

The guidance allows interventional physicians to incorporate evidence-based strategies into their practice, tailored specifically towards fistula creation. By integrating these strategies, the SIR hopes to improve patient outcomes and overall satisfaction.

“Ensuring that interventional radiologists are recognized as vital components of the patient care team will bolster the enhancement of patient outcomes across the board,” added Dr. Lookstein.

About the Society of Interventional Radiology

The Society of Interventional Radiology, a nonprofit professional medical society, encompasses over 8,000 members committed to optimizing patient care through cutting-edge image-guided therapies. The society's diverse membership spans various professional backgrounds, including medical students, residents, university faculty, and practicing interventional physicians. Additional resources and updates from SIR can be accessed through their website, sirweb.org.

The Journal of Vascular and Interventional Radiology

The Journal of Vascular and Interventional Radiology (JVIR), which has been a cornerstone for the interventional radiology community since 1990, serves as the official journal of SIR. It continuously provides groundbreaking updates in the field, covering clinical, translational, and health policy research pertinent to vascular and interventional radiology professionals.

For those interested in exploring the full spectrum of the new guidelines, they can be viewed online at jvir.org.

The newly released practice guidance highlights the urgent need for effective dialysis access solutions and reinforces the commitment of interventional radiologists in improving care for patients with end-stage renal disease.