Real-world effectiveness of rope-ladder in situ cannulation in reducing pain and complications for hemodialysis patients with autogenous arteriovenous fistula.

Purpose: To evaluate the real-world effectiveness of the rope-ladder in situ puncture technique in autogenous arteriovenous fistulas (AVF) for hemodialysis patients.

Methods: A retrospective analysis was conducted on 88 AVF patients from the Hemodialysis Center of Cangzhou Central Hospital. The observation group ( = 40) received the Rope Ladder-in-Situ Cannulation Technique (RLiSCT), while the control group ( = 48) underwent conventional rope-ladder or area puncture. Outcomes included puncture pain scores (Numeric Rating Scale, NRS), single-puncture success rate, aneurysm incidence, and complication rates.

Results: Baseline characteristics were comparable between groups ( > 0.05). At 1 month, single-puncture success rates showed no significant difference ( > 0.05). By 3 and 6 months, the observation group achieved 100% success, significantly higher than the control group (91.83% and 94.39%,  < 0.05). At 12 months, the observation group demonstrated lower pain scores (4.36 ± 1.65 vs 6.23 ± 2.01,  < 0.05), reduced aneurysm incidence (2.50% vs 16.67%,  < 0.05), and fewer total complications (7.50% vs 31.25%,  < 0.05).

Conclusion: The rope-ladder in situ puncture technique reduces pain, improves single-puncture success rates, and lowers aneurysm risk without increasing overall complications, supporting its clinical utility in hemodialysis AVF management.