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A vascular access is considered the life line of patients on hemodialysis, but unfortunately the success rate of their initial use and also longevity remain sub-optimal. This leads to inadequate hemodialysis with potentially disastrous consequences. Other serious complications that are often fatal include ...

A vascular access is considered the life line of patients on hemodialysis, but unfortunately the success rate of their initial use and also longevity remain sub-optimal. This leads to inadequate hemodialysis with potentially disastrous consequences. Other serious complications that are often fatal include infection and bleeding.

While a native arteriovenous fistula, once matured, has very good performance, a large number of patients do not have adequate vessels to support its construction and continuous use. Although native arteriovenous fistulas still require continuous monitoring and surveillance, these measures are far more likely to diagnose problems with other methods used for hemodialysis, which are mostly prosthetic grafts and catheters.

There have been many achievements in the field:
• Continuous research has improved materials and methods used in vascular access.
• State of the art preoperative vessel mapping, using mainly Duplex ultrasound, has greatly improved patient selection for creation of an arteriovenous fistula.
• Percutaneous fistula creation has proven to be effective in a sizeable proportion of candidates, obviating the need for a surgical incision.
• Novel early cannulation prosthetic grafts allowing immediate cannulation have been developed, reducing catheter dependence.
• New drug eluting balloons have emerged, improving the longevity of fistulas and grafts.
• The use of stenting in case of a failed or failing vascular access has also been better clarified.

The goal of this Research Topic is to describe the state of the art in vascular access, describing all recent advances in the field.

Authors are encouraged to submit manuscripts on topics related to the field, including, but not limited to:
1) State of the art preoperative vessel mapping: impact on current practice and results.
2) Percutaneous fistula creation: indications, techniques and results.
3) Surgical techniques used in vascular access, focused on variations of existing methods.
4) Novel early cannulation prosthetic grafts allowing immediate cannulation: types and results. Are they underused and what are the obstacles?
5) New drug eluting balloons to treat stenoses in a vascular access.
6) Use of stenting in case of a failed or failing vascular access: moving forward.
7) Exotic or rare vascular access types, as a last resort to deliver efficient hemodialysis.
8) Hemodialysis catheters: measures to improve longevity and reduce infection rates.

Keywords: vascular access, prosthetic graft, arteriovenous fistula, hemodialysis, hemodialysis catheter


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