SIR Guidelines on Percutaneous Dialysis AVF

A Society of Interventional Radiology Practice Guidance Document on Percutaneous Arteriovenous Fistulae for Dialysis Access

🔍 **Clinical Question:**  

What are the up-to-date society-based consensus recommendations for the creation and maturation of percutaneous arteriovenous fistulae (pAVFs) for hemodialysis access?

💡 **Key Insight:**  

Vessel mapping is essential for successful pAVF creation, evaluating inflow arteries, perforator vein(s), and superficial outflow veins.

Although technical success of pAVF creation is >95%, patients should be aware that many of the fistulae will require additional procedures to ensure fistula maturation. Successful cannulation rates are approximately 80%.

The interventionalist is responsible for postprocedural pAVF management, which usually includes a follow-up visit 1–2 weeks after creating a pAVF. 

Use the appropriate Current Procedural Terminology (CPT) code (36836 or 36837) for percutaneous creation of upper extremity AVFs (these codes refer to procedures performed via single or dual access sites.)

👉 **Why it matters:**  

Percutaneous AVF creation offers many benefits over surgical AVFs with ongoing evidence of its safety and effectiveness. This practice guidance document serves as a summary of what is required to develop a pAVF program, including patient preparation, performance of the procedure, adverse event management, and follow-up care.

➡️ **Full Article:** 

https://doi.org/10.1016/j.jvir.2025.08.019

#InterventionalRadiology #VascularIR #AVF #Hemodialysis #PercutaneousAVF #PracticeGuideline #PracticeBuilding #MedEd