Dialysis Access Anatomy and Interventions: A Primer.

Area of Science:

• Vascular Surgery
• Nephrology
• Interventional Radiology

Background:

• Arteriovenous fistulae (AVF) and arteriovenous grafts (AVG) are essential for long-term hemodialysis access.
• These accesses provide a lifeline for patients with end-stage renal disease requiring renal replacement therapy.
• Failure of these accesses can significantly impact patient morbidity and mortality.

Purpose of the Study:

• To outline common surgical approaches for creating dialysis access.
• To describe interventional techniques for treating common causes of access dysfunction.
• To enhance understanding of vascular access management for interventionalists.

Main Methods:

• Review of common surgical techniques for AVF and AVG creation.
• Discussion of diagnostic and interventional strategies for access stenosis, thrombosis, and infection.
• Emphasis on the anatomical considerations for successful access placement and maintenance.

Main Results:

• Surgical creation of AVF and AVG remains a cornerstone of dialysis access.
• Interventional radiology offers effective treatment options for various access pathologies.
• Timely diagnosis and management of access dysfunction are critical for preserving patency.

Conclusions:

• A thorough understanding of dialysis access anatomy and pathology is essential for interventionalists.
• Both surgical and interventional approaches are vital for successful long-term dialysis access.
• Optimizing access management improves patient outcomes in renal replacement therapy.