Alternative vascular access in patients lacking veins for standard arteriovenous fistulae

We have evaluated the Hickman catheter and Hemasite access port as means to re-establish vascular access in patients lacking veins for conventional arteriovenous fistulae. The Hemasite is more convenient, but is also costlier, requires more surgical skill to implant, and is more frequently associated with major infections. One-half of the Hemasites have failed because of infection. As a result, the long-term survival rate is lower for Hemasite graft, although the differences noted have not yet reached statistical levels of significance.