Help Restore AV Access

with the 6F & 8F Aspirex™ Thrombectomy Catheters

The Aspirex™ Mechanical Aspiration Thrombectomy System offers a 3-in-1 mechanism of action designed to aspirate, macerate, and transport clot out of arteriovenous grafts and fistulas.

ADVANCED ASPIRATION

Rotating internal helix creates powerful suction at the catheter tip, aspirating clot through a wall-apposed side window

CONTINUOUS MACERATION

Clot is macerated by the internal helix as it enters the catheter and is continuously macerated as it travels through the catheter to help mitigate clogging

MECHANICAL TRANSPORTATION

Internal helix helps transport clot through the catheter and out of the vessel

Vascular Titans

SVS honors two with Lifetime Achievement Award

The SVS on Thursday honored two surgeons—instead of the traditional one—with its highest honors, the Lifetime Achievement Award. It’s only the third time the Society has done so in the award’s history, said Michael C. Dalsing, MD. He presented the honorees: Enrico Ascher, MD, professor of surgery at NYU Langone School of Medicine, and Julie Freischlag, MD, formerly dean of Wake Forest University School of Medicine and now chief academic officer of Advocate Health. Freischlag was SVS’ first—and still only—woman president. Both Ascher and Freischlag are “exceptionally deserving of this prestigious distinction,” said Dalsing. SVS will profile the two recipients in the July issue Vascular Specialist.

Maturation

Nephrologist insights for vascular surgeons at hemodialysis access session

FRIDAY AFTERNOON IN POTOMAC D WILL SEE VAM PLAY HOST TO A SERIES of presentations on access for hemodialysis that will offer education on arteriovenous fistulas (AVFs), grafts (AVGs) and maturation—as well as strategies for managing their failure.

The session will be moderated by Maureen Sheehan, MD, of Wake Forest University Medical Center, North Carolina, and Thomas Huber, MD, from the University of Florida in Gainesville, and is titled “Creation and Complications: Current Strategies in Hemodialysis Access.” Split into two sections, the 90-minute program will focus first on access creation, with Vandana Dua Niyyar, MD, President of the American Society of Diagnostic and Interventional Nephrology (ASDIN), offering up an interventional nephrologist’s angle on the creation of dialysis access.

Speaking to VS@VAM, Huber—among those behind the program—said: “The hope was that we could get someone from the outside that could share their perspective. We’ve tasked [Niyyar] with telling us what vascular surgeons need to know from a nephrologist’s perspective.”

Next up will come Theodore Yuo, MD, of the University of Pittsburgh Medical Center, who will explore endovascular AVF (endoAVF), before Libby Weaver from the University of Virginia Health System will talk AVG materials and Yana Etkin, MD, Zucker School of Medicine at Hofstra/Northwell, Long Island, New York, will explore access maturation strategies.

Following a 15-minute panel discussion, the second half of the session will get underway with a talk on the management of failing AVGs and AVFs from Jeffrey J. Siracuse, MD, from the Boston School of Medicine in Boston. Management is the name of the game in this whole second sequence of talks—with management of everything from high-flow AV access the focus of Samuel S. Ahn of TCU & UNTHSC School of Medicine, Fort Worth, to the management of access emergencies rounding out the session in a talk from Huber himself. Detailing his talk, Huber told VS@VAM that he will turn the spotlight on “aneurysms and pseudoaneurysms that are not recognised and treated definitively.” Benjamin Roche

FRIDAY MORNING’S PLENARY

Session 5 (8:00–9:30 a.m.) is set to feature new data on an external support device that may deliver more functional arteriovenous fistulas (AVFs) while also offering an improvement in costeffectiveness. Presenting an abstract on research into the VasQ device will be Ellen D. Dillavou, MD of WakeMed Hospital in Raleigh, North Carolina.

The study explored the support device’s ability to improve functional success in AVF over a 24-month period. Dillavou is set to deliver “the first complete report of the U.S. pivotal comparative study results”, alongside a cost-effectiveness analysis. Over the study, she will detail, 144 patients were enrolled—90% of them receiving a brachiocephalic and 10% a radiocephalic fistula. Some 782 patients treated by

Ellen D. Dillavou

the same surgeons without the VasQ device immediately before enrollment in the trial were identified as a comparative group, with their Medicare claims data utilized for comparison. Statistical comparison was then performed between the groups with regards to primary patency—defined as freedom from intervention—as well as functional success (continuous use for dialysis after 30 days) and post-creation reintervention. Payor cost was taken into consideration alongside each of these outcomes.

“Primary failure of 7.9% for VasQ AVF patients compared favorably to the 22% to 32.2% reported in contemporary U.S. meta-analyses,” the study authors report, while the cumulative patency for the VasQ device of 76.7% (95% confidence interval [CI]: 67.7–83.4%) was found to be “superior to contemporary metaanalyses,” which the authors say report between 53.7% to 63% for standard AVFs. There was a “nearly 50% reduction in access interventions” with the device at six months, which the authors argue led to the annualized cost reduction they found of US$7,764.19 per patient year.