Efficacy and safety of implantable vascular support in the treatment of arteriovenous fistula: A single-arm meta-analyses

Abstract

Background and objectives: VasQ (Laminate Medical Technologies, Israel) is an external support device for autologous arteriovenous fistula (AVF) designed to improve anastomotic blood flow and reduce neointimal hyperplasia. However, different studies have shown that the efficacy of the VasQ device in improving AVF is inconsistent. The purpose of this study was to conduct a meta-analysis to further evaluate the efficacy and safety of the VasQ device. Design, setting, participants, and measurements: Two reviewers independently searched studies published in PubMed, EMBASE, Cochrane, Web of Science, CNKI, and Wan Fang databases from inception to 2023. The Cochrane Systematic Evaluation Bias Risk Tool Version 1 was used to assess the risk of RCTS bias. The ROBINS-I tool was used to assess the risk of bias in non-randomized studies. A Single-arm meta-analysis was performed, and a random effects model was used for all analyses. Results: We identified six trials involving 146 patients and conducted a meta-analysis. The results showed that after 6 months of VasQ device treatment, the primary patency rate of AVF was [76.4% (95%CI: 0.608–0.920), p < 0.01] while the secondary patency rate was [76.5% (95%CI: 0.572–0.958), p < 0.01]. The maturity rate of AVF 1 month after surgery was [88.5% (95%CI: 0.818–0.952), p = 0.46]. The incidence of anastomotic stenosis was [8.9% (95%CI: 0.015–0.163), p = 0.23], and the incidence of anastomotic venous thrombosis was [10% (95%CI: 0.035–0.179), p = 0.38]. Conclusions: Meta-analysis data of this study show that the VasQ device has a good effect in improving the patency rate of AVF and does not increase the occurrence of adverse events. However, due to the limitation of the number and quality of included studies, more high-quality studies are needed to confirm this in the future.