The Japanese Journal of Clinical Dialysis Vol.30 No.2(9)

Theme Vascular access -- Creation, management, repair : the individualization based on the standardization
Title Buttonhole technique for fistula cannulation
Publish Date 2014/02
Author Yoshiaki Takemoto Department of Artificial Kidney, Osaka City University Medical School
Author Toshihide Naganuma Department of Artificial Kidney, Osaka City University Medical School
[ Summary ] Vascular access remains an Achilles heel for hemodialysis patients. Arteriovenous fistulas (AVF) are the preferred type of vascular access because of the minimal number of complications and longest patency rates. Needle insertion techniques have important effects on long-term patency AVF rates. Traumatic events caused by incorrect needle insertion may cause hematoma formation, associated with an increased risk of thrombosis. The buttonhole technique has been reported to be associated with fewer AVF complications and reduced puncture pain. We discuss observations drawn from a study and RCT research on the buttonhole technique. No reductions in puncture pain using the buttonhole technique were observed in RCT research.
As a result, it is thought that proper patient selection to employ the advantages of the buttonhole technique efficiently is very important.
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