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Pioneering trial offers huge benefits for patients needing dialysis recognised by The Lancet

Tuesday, August 2, 2016

A pioneering trial led by a number of NHS Greater Glasgow & Clyde surgeons and anaesthetists to improve the treatment of dialysis patients has been recognised in the prestigious international journal The Lancet.

The results of the trial, led by one of our surgical registrars, have seen remarkable benefits for patients who require an arteriovenous fistula (an artificial passageway between an artery and a vein) before beginning dialysis.

Normally, the surgical procedure to create a fistula is carried out under either general anaesthetic or only a localised area of the patient’s arm is numbed. Unfortunately for some patients this operation has to be carried out a number of times before being successful.

By using a regional anaesthetic the patient’s arm is frozen from the shoulder down and this is proving a huge benefit in terms of improved vascular access for dialysis. 

It is a personal accolade for Dr Emma Aitken, Registrar at the Queen Elizabeth University Hospital, who led the three year trial involving around 130 patients along with Marc Clancy, consultant surgeon, and Alan Macfarlane, consultant anaesthetist.

Dr Aitken said: “I am delighted that the output from this trial show significant benefits for patients. 

“On a personal level, having world leaders read about our work makes me feel extremely proud as the Lancet is an international publication and only accepts five per cent of the submissions it receives.” 

Alan Macfarlane, consultant anaesthetist, NHS Greater Glasgow and Clyde, added:  “These are important results which will deliver huge patient benefits in terms of improved vascular access for dialysis by reducing the number of repeat operations required.  

“I think the study could have a major influence on how anaesthesia for fistula surgery is performed worldwide.” 

The paper can be viewed at:

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Last Updated: 11 November 2021