Introducing a vascular Enhanced Recovery Programme (ERP) – The patient perspective

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however clinical assessment remains the gold-standard test for initial maturity.We aimed to assess whether radiological assessment was delaying cannulation in patients with clinically maturing fistulas.Methods: Single-centre, retrospective analysis of all established haemodialysis patients, who underwent AVF formation between January 2015-August 2017.Electronic records were interrogated for time to first cannulation, clinical evidence of maturity at 6 weeks and radiological followup.A Mann-Whitney U Test was employed for statistical significance.Results: 76 patients underwent AVF formation (male¼51) with brachiocephalic being the most common procedure performed (RCF¼19, BCF¼39, BBF¼17, other¼1).61 (80.3%) of fistula were clinically maturing at 6 weeks.The overall median time to first cannulation and follow-up ultrasound was 64 days (IQR¼53-93) and 72 days (52-137) respectively.19 (31.1%) patients with clinically maturing fistulae had cannulation delayed until radiological results.Median time to cannulation in this group was 77 days (64-125), compared with 64 days (49-82) in patients were cannulation was based on clinical findings alone (p¼0.02).Conclusion: Radiological assessment is a useful adjunct to care but is associated with delay in cannulation if not used in conjunction with clinical assessment.

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