Problems and prospect of internal arterio-venous fistula for hemodialysis

Vascular access for dialysis in patients with terminal renal failure has assumed increasing importance on surgical services as more and more facilities are developing to support such patients for longer period. Longevity of such vascular access is aimed for, meticulous care is needed in its creation. Direct arterio-venous fistula is best method available, but in case of its failure, fistula formation using graft is useful alternative. Complications associated with vascular access still represent one of the most frequent and significant problems encountered in a hemodialysis center. Measures to overcome such problems are discussed. Historical background and literature are reviewed. Seven patients treated with maintenance hemodialysis are presented. One of them had severe haemorrhage from the fistula, an unusual complication of internal arterio-venous fistula.