Multiple Single Cannulaton Technique for Puncturing Arteriovenous Fistulas: Randomized Comparison With Rope Ladder Technique Cannulation.

Abstract

Objective: This study aims to evaluate the impact of multiple single cannulation technique (MuST) on complications associated with arteriovenous fistulas (AV fistulas) in hemodialysis patients.

Methods: Patients who initiated hemodialysis using AV fistulas at our hospital between August 2023 and December 2023 were selected using convenience sampling. Participants were randomly assigned to either the control group or the experimental group using a random number table, with odd-numbered patients placed in the control group and even-numbered patients in the experimental group. The experimental group received MuST, while the control group received the rope ladder cannulation technique. After 12 months of follow-up, we assessed the incidence of aneurysms, thrombosis, infiltration, and stenosis, along with the cannulation success rate. Pain levels were evaluated using the Visual Analogue Scale (VAS) for pain, and cannulation difficulty was rated using Likert's five-point scale.

Results: The experimental group exhibited significantly lower incidences of aneurysms (3.44% vs. 15.3%), thrombus (1.72% vs. 13.6%), and stenosis (1.72% vs. 11.7%) compared to the control group (p < 0.05). The cannulation success rate was also significantly higher in the experimental group (99.5% vs. 99.0%) (p < 0.05). Moreover, the experimental group reported significantly lower cannulation difficulty scores (1.41 ± 0.54 vs. 2.24 ± 1.04) and pain scores (1.82 ± 0.93 vs. 3.29 ± 0.77) (p < 0.05). However, the incidence of infiltration was significantly higher in the experimental group (19.0% vs. 6.78%).

Conclusions: MuST was associated with reduced pain and higher success rate of cannulation, and fewer complications compared to the standard rope ladder method. However, it was linked with a higher rate of infiltration. These findings suggest that MuST may be a promising alternative and warrants further investigation and broader clinical adoption.