ABSTRACT
Fifty years since the development of hemodialysis (1), a dependable method of chronic access to the circulation remains elusive. An optimal angioaccess should allow high flow, be easy to cannulate, not create distal hypoperfusion, and last indefinitely. Few would argue that autogenous arteriovenous (AV) fistulae come closest to this standard. This is also the view of the National Kidney Foundation Kidney Disease Outcomes Quality Initiative, as cited throughout this text. The following is both a technical and philosophical look at autogenous access for hemodialysis.
