title: Novel Use of a Pneumatic Compression Device for Haemostasis of Haemodialysis Fistula Access Catheterisation Sites.
abstract: OBJECTIVE
  Transradial pneumatic compression devices can be used to achieve haemostasis following radial artery puncture. This article describes a novel technique for acquiring haemostasis of arterio-venous haemodialysis fistula access sites without the need for suture placement using one such compression device.
  
  
  METHODS
  A retrospective review of fistulograms with or without angioplasty/thrombectomy in a single institution was performed. 20 procedures performed on 12 patients who underwent percutaneous intervention of failing or thrombosed arterio-venous fistulas (AVF) had 27 puncture sites. Haemostasis was achieved using a pneumatic compression device at all access sites. Procedure details including size of access sheath, heparin administration and complications were recorded.
  
  
  RESULTS
  Two diagnostic fistulograms, 14 fistulograms and angioplasties and four thrombectomies were performed via access sheaths with an average size (±SD) of 6 Fr (±1.12). IV unfractionated heparin was administered in 11 of 20 procedures. Haemostasis was achieved in 26 of 27 access sites following 15-20 min of compression using the pneumatic compression device. One case experienced limited bleeding from an inflow access site that was successfully treated with reinflation of the device for a further 5 min. No other complication was recorded.
  
  
  CONCLUSIONS
  Haemostasis of arterio-venous haemodialysis fistula access sites can be safely and effectively achieved using a pneumatic compression device. This is a technically simple, safe and sutureless technique for acquiring haemostasis after AVF intervention.
authors.affiliation: Department of Interventional Radiology, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland. moreilly1@mater.ie.
authors.forename: Michael K
authors.initials: MK
authors.lastname: O'Reilly
authors.affiliation: Department of Interventional Radiology, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland.
authors.forename: David
authors.initials: D
authors.lastname: Ryan
authors.affiliation: Department of Interventional Radiology, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland.
authors.forename: Gavin
authors.initials: G
authors.lastname: Sugrue
authors.affiliation: Department of Interventional Radiology, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland.
authors.forename: Tony
authors.initials: T
authors.lastname: Geoghegan
authors.affiliation: Department of Interventional Radiology, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland.
authors.forename: Leo P
authors.initials: LP
authors.lastname: Lawler
authors.affiliation: Department of Interventional Radiology, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland.
authors.forename: Cormac T
authors.initials: CT
authors.lastname: Farrelly
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001164:Arteriovenous Fistula / Q000209:etiology / Q000628:therapy*; D005260:Female; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Arterial closure devices; Arterio-venous fistula puncture; Haemodialysis intervention; Haemostasis; Pneumatic compression device