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VWING™ Vascular Needle Guide: Guided AV Fistula Cannulation

The VWING Vascular Needle Guide

The VWING is a subcutaneous needle guide that allows for repeatable and reliable hemodialysis access of an autogenous arteriovenous (AV) fistula. The VWING facilitates access to deep and difficult to cannulate fistulas, extends the usable length of fistulas, and can help salvage aneurysmal fistulas.

VWING’s unique design enables a new way of performing constant site cannulation:

Palpatation Ridge

Palpation ridge indicates the fistula location and optimal skin insertion point.

Funnel Shape

Funnel shape guides the needle to a consistent vessel entry point.

Consistent Tissue Path

Encapsulation by granulation tissue facilitates formation of a consistent tissue path between skin and vessel.

Potential Infection Barrier
Provides separation between skin and vessel entry points — a potential infection barrier.
Improving Vascular Access for Dialysis Patients

The VWING is a subcutaneous needle guide that allows for repeatable and reliable hemodialysis access of an autogenous arteriovenous (AV) fistula. The VWING facilitates access to deep and difficult to cannulate fistulas, extends the usable length of fistulas, and can help salvage aneurysmal fistulas. The VWING acts as a target for a single cannulation site, enabling use of blunt needles following establishment of a needle tract.

The VWING is comprised of a single piece titanium device that allows for repeated access of the fistula through a single puncture site for maintenance hemodialysis. The VWING is implanted beneath the skin through a simple surgical procedure and securely attached to the exterior fistula wall, making the VWING a subcutaneous and extra-vascular cannulation target.

The VWING is a tool that aids surgeons, nephrologists and cannulators in the ultimate goal of providing reliable and safe dialysis access.


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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 simple alternative, and may be the best option to revise uncannulatable fistulas.

  • Provides lower risk option to elevation or other superficialization of deep vessels4
  • 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 easily 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 Fistulas2
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 Easy and Minimally Invasive

The single piece titanium VWING is easily 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 easy subcutaneous target and guide for a wide variety of anatomies, including deep AVF
  • 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 time1
  • Facilitates transition to blunt needles to minimize vessel damage
VWING Demonstrated Excellent Safety and Efficacy in the U.S. SAVE Prospective, Multi-Center Clinical Study2
  • 96% success of primary endpoint (cannulation of previously uncannulatable AVF)
  • 100% secondary functional fistula patency at 6 months
  • Systemic infection was 0.038 per patient year
Very Low Infection Rate*
Adverse Events Catheter (USRDS) AV Fistula (USRDS) VWING SAVE Study Rate2
Infection of access 1.45 0.18 0.038
Sepsis 2.32 0.52 0.038

* Per patient year


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VWING Guided Cannulation Technique: A Revolution in Constant Site Cannulation

Provides a Safe, Consistent and Predictable Path to the Fistula

Constant site cannulation using blunt needles has been advocated as a means to overcomethe damaging effects of sharp needle cannulation experienced in rope ladder and area puncturecannulation techniques.  Until now, buttonhole cannulation using a “freehand” technique was the only way to create a constant site. Buttonhole, however, has many limitations: it is unguided, relies heavily on the cannulator’s skill set and the patient’s anatomy, and is affected by shifting arm and fistula positions from one dialysis session to the next. Because there are no means to ensure a single cannulation path, multiple vessel puncture sites, increased trauma to the skin insertion point and other complications may result, leading to an increased risk of infection and aneurysm.

VWING’s unique design enables a new way of performing constant site cannulation:

  • Palpation ridge indicates the fistula location and optimal skin insertion point
  • Funnel shape guides the needle to a consistent vessel entry point
  • Encapsulation by granulation tissue facilitates formation of a consistent tissue path between skin and vessel
  • Provides separation between skin and vessel entry points — a potential infection barrier3
  • Systemic infection rate was .038 per patient year in the U.S. SAVE Study2

VWING Guided Cannulation Technique standardizes the cannulation path and guides the needle to a single vessel entry point to ensure safe, consistent and predictable 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 1,100 kB
3 Product Summary 848 kB
4 Marketing Presentation 857 kB
5 Clinical Trial 457 kB
6 Reimbursement Guide 136 kB
7 Patient ID Card 113 kB
8 VWING Order Form 280 kB
9 Patient Information Sheet 232 kB
10 First in Human Publication 273 kB
11 SAVE Study Publication 1,335 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
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*Jennings, 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.