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A more cost effective, clinically sound approach to hemodialysis treatment

More than 7 percent of the Medicare budget is spent on managing patients with end-stage renal disease.

Jeff Lagasse, Associate Editor

A new healthcare analysis shows that a catheter-based endovascular system for creating hemodialysis access offers significant quality-of-life benefits and cost savings compared to the traditional surgical approach in end-stage renal disease patients. 

The retrospective analysis compared the everlinQ endoAVF System from TVA Medical with surgical arteriovenous fistula creation -- or "open surgery," as it's referred to commonly.

Compared to surgical arteriovenous fistula placement, or AVF patients, endoAVF patients had nearly double the number of days with a functioning AVF for dialysis; spent less time using a central venous catheter (83 vs. 261 days), leading to improvements in quality-adjusted life years, and needed fewer interventions, resulting in an average of 90 percent lower related costs -- $1,271 vs. $13,031 -- in the first year after receiving an AVF.

In the endoAVF procedure, two flexible magnetic catheters are inserted into an artery and vein in the arm. A small amount of radiofrequency energy is used to connect the artery and vein to create the fistula. The catheters are then removed and a brachial vein is coil-embolized, enabling future dialysis.

More than 7 percent of the Medicare budget is spent on managing patients with end-stage renal disease, according to the analysis. Non-functional AVFs contribute to the rising costs of treating hemodialysis patients, and new approaches are needed to mitigate this effect.

More than 400,000 people in the U.S. receive hemodialysis multiple times a week. About 3 million people worldwide with ESRD are treated with hemodialysis each year.

The approach is one of several new strategies for mitigating clinical costs. Technology from glucose monitors to telehealth have also shown cost saving potential without sacrificing clinical quality.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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