FIRAPY is a physical treatment utilizing infrared radiation with longer wavelengths than visible light. This energy, has applications in health promotion and wound healing. FIRAPY is delivered via a device with ceramic plates, placed above an arteriovenous fistula (AVF) during hemodialysis sessions. Studies suggest that FIR enhances blood flow and patency in AVFs, reduces pain from steal syndrome, and inhibits endothelial inflammation, addressing key factors in AVF stenosis and thrombosis.

A study at Raigmore Hospital, Inverness, highlighted FIRAPY's impact on reducing fistuloplasty frequency. Comparing data from 2011-2013 to 2014-2016, after FIRAPY was introduced, showed a 21% reduction in procedures. Individual cases demonstrated extended intervals between fistuloplasties following FIR initiation. Despite barriers like cost, staff training, and patient refusal, FIRAPY therapy proved effective, convenient, and cost-saving, reducing hospital stays for hemodialysis patients with AVF complications.

Patient Selection

• Poor maturation of AVF
• After first or requiring regular fistuloplasty
• Steal Syndrome
• Patients referred from weekly vascular MDT

Application of FIRAPY

• To be used on native AV fistulae only
• Fistula limb must be uncovered
• Applied during every dialysis session, 40 min duration

Result

Conclusion

Arthur: Dr Susan Stewart

Site: Raigmore Hospital, Inverness, UK

Presented at the 2017 BRS Conference.