Effect of the modified RADAR, No-touch, and conventional techniques on arteriovenous fistula outcomes.

OBJECTIVE

Low primary patency rates represent a major problem of radiocephalic arteriovenous fistula (RC-AVF). No-touch techniques and radial artery deviation and reimplantation (RADAR) were reported and used in RC-AVF creation. To enhance RC-AVF outcomes, we devised a modified RADAR technique and conducted a retrospective study comparing this approach with no-touch and conventional methods for RC-AVF creation.

METHODS

We retrospectively reviewed patients undergoing RC-AVF creation for hemodialysis using either the modified RADAR, no-touch, or conventional technique between January 2023 and December 2024. The primary patency, juxta-anastomotic stenosis, and maturation rates of the three techniques were compared and analyzed.

RESULTS

In total, 289 patients were included. The incidence of anastomotic stenosis was significantly lower (p = 0.030) in the modified RADAR group (33.33%) than in the no-touch technique (60.32%) and conventional technique groups (50.40%). The AVF maturation rate within 6-8 weeks was significantly higher (p = 0.005) in the modified RADAR group (90.70%) than in the no-touch technique (67.06%) and conventional technique groups (65.84%). At 3, 6, 9 and 12 months postoperatively, the primary patency rates in the modified RADAR group were 90.7%,88.37%, 86.05% and 86.05%, respectively. Significant differences were observed among the three groups (log-rank p = 0.04).

CONCLUSION

The modified RADAR technique for RC-AVF creation resulted in higher primary patency, lower juxta-anastomotic stenosis, and improved maturation rates.