AB074. SOH25_AB_239. Introduction of a new arteriovenous access pathway at University Hospital Limerick (UHL)

Background: In Ireland, between 2010 and 2020, the number of patients with end stage renal disease (ESRD) requiring haemodialysis (HD) has increased by 36%. Arteriovenous fistulas (AVFs) provide patients with best quality HD as they are associated with less complications. Current guidelines state that permanent vascular access should be placed 3 to 6 months prior to commencing HD. In UHL, a pathway has been created to help ensure these patients receive arteriovenous access in a timely manner.

Methods: Times from date of referral for vascular imaging to the date of duplex scan and date of referral to the date of surgery were assessed. The average wait time to scan and to surgery was determined. An arteriovenous access protocol will be introduced throughout the Renal Medicine, Renal Dialysis and Vascular Imaging departments. The second cycle of the audit will be carried out after two months.

Results: Nineteen patients received an AVF from April to November 2024. Of these 19 patients, 8 were referred directly to vascular imaging. The remainder were referred as an inpatient or to the outpatient department (OPD). The overall average time for a patient to undergo duplex imaging was 5 days. The average wait time from date of referral to AVF placement was 25 weeks. However, the average wait time for patients who were directly referred to vascular imaging was 8 weeks.

Conclusions: For patients referred directly to vascular imaging, the average time to receive arteriovenous access is less. Patients would benefit from introduction of a new arteriovenous access protocol at UHL.

Keywords: Arteriovenous access; arteriovenous fistula (AVF); end stage renal disease (ESRD); haemodialysis (HD); vascular imaging