Creating an Ellipsys percutaneous arteriovenous fistula after a failed ipsilateral WavelinQ fistula: A case report of an endovascular approach for access restoration

Abstract

The introduction of devices for endovascular dialysis access creation (WavelinQ and Ellipsys) offers practitioners more options for access management in dialysis patients. Especially in terms of reducing the usage of central venous catheters, a native fistula is desirable as an initial dialysis access. We present a case in which a failed WavelinQ type fistula was reactivated using the Ellipsys procedure on the same arm. This specific rescue method is based on the idea that the proximal part of an endoAVF from an earlier WavelinQ procedure which resulted in adequately dilated veins, comprising the perforating vein, may allow a subsequent Ellipsys procedure. This case report shows how the use of endovascular techniques such as WavelinQ and Ellipsys can be incorporated in a clinical context and create new options for the patient.