Cadaveric Feasibility of A 3D-Printed Vaso-Stent for Sutureless Anterior Interosseous Artery-Cephalic Vein Anastomosis: A Novel Approach to Arteriovenous Access Creation.

Abstract

Arteriovenous fistulas (AVFs) are the gold standard for vascular access to facilitate hemodialysis, yet traditional surgical techniques are technically demanding, time-intensive, and costly. Additionally, limited suitable AVF sites, due to patient anatomy, vessel quality, and prior access exhaustion, necessitate exploration of novel options. This cadaveric proof-of-concept study introduces the anterior interosseous artery-cephalic vein as a novel AVF site and evaluates the feasibility of a 3D-printed sutureless anastomotic device, the Vaso-Stent, compared to conventional handsewn techniques. Fresh-frozen cadaveric upper limbs were procured to test the surgical feasibility of the proposed AVF model. Surgical exposure of the interosseous artery and adjacent cephalic vein were uncomplicated. A 3D-printed Vaso-Stent was manufactured and facilitated efficient anastomosis in under 1 min, compared with the 4.5 min required for a standard handsewn technique. The device demonstrated ease of placement, robust structural integrity, and resistance to tensile forces. These findings highlight that the Vaso-Stent can provide a simple alternative for AVF creation that reduces operative time and highlight the anterior interosseous artery-cephalic vein configuration as a new and unique hemodialysis access opportunity.