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VWING Vascular Needle Guide
Guided AV Fistula Cannulation

  • Improved access to challenging fistulas1
  • Low risk of complications and infections1
  • Sustainable, long term access2

VWING

The VWING Vascular Needle Guide:

The VWING is a subcutaneous needle guide which has been demonstrated to provide safe and reliable access in challenging to cannulate AV fistulas. Examples of challenging to cannulate fistulas the VWING may help improve access to:

  • Mature fistula that falls outside of KDOQI’s guidance for depth (greater than 6mm)
  • Short segment fistula with limited space for site rotation
  • Aneurysmal fistulas at risk of further damage
Improving AVF Access Success for Dialysis Patients

Arteriovenous fistulas (AVF's) are referred to as the "Gold Standard" access for performing hemodialysis treatments. AVF's are associated with3:

  • Lower risk of infection than grafts or catheters
  • Lower tendency to clot than grafts or catheters
  • Greater blood flow, increasing the effectiveness of hemodialysis treatments
  • Stays functional longer than other access types
  • Less expensive to maintain

Despite recent increases in AVF placement, studies have shown that often times AVF's are inaccessible several weeks after creation. In fact, a recent study revealed that nearly 40% of AVF's required surgical revision in order to gain successful access for hemodialysis treatments4.

The inability to cannulate an AVF prolongs catheter time and exposes patients to higher risk of infection and hospitalization, resulting in a decline in patient outcomes, missed dialysis treatments, and increased cost of care3.

The VWING was designed to safely and reliably improve fistula access success and has demonstrated1,2:

  • Improved access to challenging AVFs that were deemed uncannulatable
  • Low rates of access complications and AVF damage
  • Lower rates of infection than non-VWING™ AVFs and catheters
  • Sustainable, long term AVF access
  • Potential to improve quality of life and reduce cost of care3

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A Safe Alternative for Establishing Cannulatable Fistulas

Revising a fistula to improve cannulatability can be challenging for vascular surgeons and poses risks for patients. VWING provides a safe and reliable option for revision of uncannulatable fistulas.

  • Provides lower risk option to elevation or other superficialization of deep vessels1
  • Offers a simple, less invasive alternative to basilic vein transposition
  • Extends the usable length of AVF with short cannulatable segment
  • Helps salvage AVF with aneurysm or damage by creating a new cannulation location
  • May provide an alternative to an AV graft
In SAVE Study, VWING Enabled Access to a Variety of Previously Uncannulatable Fistulas1
Inclusion Criteria Number of Fistulas (%) (n=54)
Not palpable 37 (69%)
3 failed access attempts 23 (43%)
Deep (>6mm) 23 (43%)
Short segment 21 (39%)
Infiltrations 16 (30%)
Tortuous 6 (11%)
Aneurysm 3 (6%)
Implantation Is Minimally Invasive

The single piece titanium VWING is implanted subcutaneously

  • Small incision of approximately 4 centimeters
  • Secured to the exterior wall of the fistula through suture holes
  • Implant procedure is efficient and predictable (typically < 30 minutes)
  • Usually performed with local anesthesia and conscious sedation
  • Ready for cannulation as early as 3 weeks after surgery
Expose the Vessel

Expose the Vessel

Suture VWING to the Vessel

Suture VWING to the Vessel

Close the Incision

Close the Incision


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Safe. Consistent. Predictable Cannulation.

Dialysis in patients with an arteriovenous fistula (AVF) requires successful cannulation, but safe, reliable, consistent cannulation can be very challenging. VWING™ from Vital Access helps remove barriers to cannulation.

  • Provides a palpable target and guide for a wide variety of anatomies, improving access to challenging to cannulate fistulas
  • Enables innovative Guided Cannulation Technique that is safe, consistent and easy to learn
  • Offers a lower risk, minimally invasive alternative to elevation and transposition procedures
  • Potentially reduces dialysis catheter time5
  • Facilitates transition to blunt needles to minimize vessel damage
Improving and Sustaining Access to Challenging to Cannulate AVF's with Low Rates of Infection:
  • 96% success of primary endpoint (cannulation of previously uncannulatable AVF's)
  • 91% Functional Patency at 18 months
  • 18 month reported systemic access infection and sepsis rates of 0.018 PPY
COMPLICATION RATES (per patient year) Catheter (USRDS) AV Fistula (USRDS) VWING™ SAVE & 18mo Rate2
Access Infection 1.45 0.18 0.018
Sepsis 2.32 0.52 0.018

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VWING Guided Cannulation: A New, Safe, and Reliable Technique for Improving Access to Challenging Fistulas:

The VWING is designed to guide the cannulator to successful AVF access:

  • Palpation ridge indicates fistula location and optimal skin insertion point
  • Funnel shape guides the needle to a single vessel entry point
  • Facilitates blunt needle access overcoming some of the damaging effects of sharp needle cannulation experienced in rope ladder and area puncture cannulation techniques
  • Encapsulation and granulation tissue forms to help facilitate a consistent tissue path between skin and vessel
  • Separation between skin and vessel entry point may serve as a potential infection barrier1

Unlike other cannulation techniques, the VWING Guided Cannulation Technique standardizes the cannulation path and guides the needle to a single vessel entry point to ensure safe and reliable fistula access:

"Free-hand" Buttonhole Technique

Buttonhole cannulation may create multiple paths from the skin to the fistula, resulting in the formation of multiple vessel puncture sites.  Prolonged reliance on sharp needles and other complications can damage the fistula and cause trauma to the skin and subcutaneous tissue, increasing risk of infection and aneurysm.

VWING Guided Cannulation Technique

VWING accurately guides the needle to a consistent vessel entry point, standardizing a path, enabling conversion to blunt needles in as few as 2-3 cannulations, and thus minimizing trauma to the fistula.

Cannulation Online Training and Certification


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# Name Size Download
1 Instructions For Use 1,741 kB
2 Brochure 220 kB
3 Product Summary 848 kB
4 Clinical Trial 457 kB
5 SAVE Study 1,335 kB
6 VWING Vascular Needle Guide to Overcome Challenges and Unsafe Cannulations 1,057 kB
7 Reimbursement Guide 136 kB
8 Patient ID Card 113 kB
9 Patient Information Sheet 232 kB
10 Pre-Dialysis Patient Welcome Letter 32 kB
11 First in Human Publication 273 kB
12 VWING Notification Form 313 kB
13 VWING Implantation Training (English) 926 kB
14 VWING Implantation Training (Nederlands) 2,308 kB
15 VWING Implantation Training (Français) 2,312 kB
16 VWING Implantation Training (Deutsch) 2,313 kB
17 VWING Implantation Training (Italiano) 2,303 kB
18 VWING Implantation Training (Español) 2,325 kB
19 VWING Guided Cannulation vs. Buttonhole Cannulation Comparison Paper 492 kB
20 VWING Cannulation Care Plan 432 kB
21 VWING Cannulation Training (English) 348 kB
22 VWING Cannulation Training (Nederlands) 1,175 kB
23 VWING Cannulation Training (Français) 1,176 kB
24 VWING Cannulation Training (Deutsch) 1,260 kB
25 VWING Cannulation Training (Italiano) 1,177 kB
26 VWING Cannulation Training (Español) 1,179 kB
27 VWING Troubleshooting Guide 182 kB
28 VWING Aneurysm Information Card 429 kB
29 The VWING Vascular Needle Guide, A Novel Method to Access Non-transposed Branchiobasilic Arteriovenous Fistulas 475 kB
30 Patient Selection Pocket Guide 163 kB
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Request a Sample How to Buy


Indications and important safety information about the VWING can be found in the IFU.

  • 1Jennings, W., Galt, S., Shenoy, S., Wang, S., Ladenheim, E., Glickman, M., & ... Brown, B. (2014). The Venous Window Needle Guide, a hemodialysis cannulation device for salvage of uncannulatable arteriovenous fistulas. Journal Of Vascular Surgery, 2014 May 13. doi: 10.1016/j.jvs.2014.04.016
  • 2Data on file, submitted for publication
  • 3NKF KDOQI Guidelines 2006 - Clinical Practice Guidelines for Vascular Access
  • 4Inkollu S, et al. Successful use of minimal incision superficialization technique for arteriovenous fistula maturation. Journal of Vascular Surgery 2015 Dec 8. pii: S0741-5214(15)02190-4.
  • 5Hill A, et al. Use of an implantable needle guide to access difficult or impossible to cannulate arteriovenous fistulae using the buttonhole technique. J Vasc Access 2013 Apr-Jun;14(2):164-9.