Innovations in vascular access for hemodialysis

Area of Science:

• Nephrology and Vascular Surgery
• Biomaterials and Regenerative Medicine

Background:

• Hemodialysis is a critical life-sustaining treatment for over 2 million patients globally.
• Well-functioning vascular access is essential for effective hemodialysis, with arteriovenous fistulas, grafts, and catheters being primary modalities.
• Historically, vascular access innovations have progressed from shunts to grafts and catheters, with recent advancements in bioengineered vessels.

Purpose of the Study:

• To review recent technological advancements in vascular access for hemodialysis.
• To highlight novel approaches for arteriovenous fistula creation and management of access-related complications.
• To emphasize the evolving paradigm of individualized vascular access placement and patient-centered care.

Main Methods:

• Review of current literature on vascular access for hemodialysis.
• Analysis of emerging technologies in bioengineered vessels and endovascular techniques.
• Discussion of challenges and future directions in vascular access care.

Main Results:

• Novel endovascular techniques show promise for simplifying arteriovenous fistula creation.
• Innovative technologies are being developed to address suboptimal treatments for access stenosis, infection, and thrombosis.
• A multidisciplinary approach is increasingly recognizing the importance of individualized vascular access strategies.

Conclusions:

• Advancements in bioengineered vessels and endovascular techniques are transforming vascular access for hemodialysis.
• Addressing challenges in access creation, maturation, and complication management is crucial.
• Patient choice and experience must remain central to the evolving field of hemodialysis vascular access care.