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    The content on this page is not current guidance and is only for the purposes of the consultation process.

    Percutaneous endovascular forearm arteriovenous fistula creation for haemodialysis access

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    Interventional procedures consultation document

    Haemodialysis removes waste products and excess fluid from the blood when the kidneys have stopped working properly. An arteriovenous fistula is a connection created to allow haemodialysis by joining a vein to an artery, usually in the forearm. Blood from the artery goes into the vein, which becomes bigger over a few weeks. This makes it possible to put 2 large needles into the vein so that blood can be taken out of the body, sent through the haemodialysis machine, and returned. Usually, the arteriovenous fistula is created surgically as an open procedure. In this procedure, the arteriovenous fistula is created by inserting 2 thin tubes (catheters) through the forearm skin (percutaneous). One tube goes into an artery and the other goes into a vein (endovascular). The tubes are positioned close to each other, sometimes using magnets, to bring the artery and vein together. Radiofrequency energy, or heat and pressure, through the tubes is then used to join the artery and vein together creating the fistula. The aim is to avoid the need for surgery.

    NICE is looking at percutaneous endovascular forearm arteriovenous fistula creation for haemodialysis access.

    NICE's interventional procedures advisory committee met to consider the evidence and the opinions of professional experts, who are consultants with knowledge of the procedure.

    This document contains the draft guidance for consultation. Your views are welcome, particularly:

    • comments on the draft recommendations

    • information about factual inaccuracies

    • additional relevant evidence, with references if possible.

    NICE is committed to promoting equality of opportunity, eliminating unlawful discrimination and fostering good relations between people with particular protected characteristics and others.

    This is not NICE's final guidance on this procedure. The draft guidance may change after this consultation.

    After consultation ends, the committee will:

    • meet again to consider the consultation comments, review the evidence and make appropriate changes to the draft guidance

    • prepare a second draft, which will go through a resolution process before the final guidance is agreed.

    Please note that we reserve the right to summarise and edit comments received during consultation or not to publish them at all if, in the reasonable opinion of NICE, there are a lot of comments or if publishing the comments would be unlawful or otherwise inappropriate.

    Closing date for comments: 25 June 2021

    Target date for publication of guidance: October 2021