[Vascular access surgery--technique and teamwork]

With the growing number of diabetics and patients with multiple problems vascular access surgery increases and therapies become more challenging. If haemodialysis is the therapy of choice for renal failure, veins of the patient's upper limbs should be preserved. Autologic fistula of the upper limb--most commonly between the radial artery and the cephalic vein--is the best option with the lowest complication risks. The purpose of vascular access surgery is to reconstruct and maintain the function of a vascular access, in collaboration with nephrologists and radiologists. To achieve this the nursing and medical personnel should be educated to use dupplex ultrasound in the diagnosis of malfunctioning accesses and needling problems during haemodialysis.