Dialysis Access Procedures

  • Khalid O. KhwajaEmail author
  • Yael Vin


Hemodialysis is the main modality for renal replacement therapy in patients with end-stage renal disease. Successful hemodialysis is contingent upon the creation of proper vascular access. Chronic vascular access was first established in 1960 by Scribner and colleagues, who created a shunt between the radial artery and the cephalic vein using an external Silastic device (Quinton et al. 1960). However, this device was fraught with problems such as bleeding, clotting, and infection. In 1966, Breschia and colleagues described a surgical fistula between the radial artery and the cephalic vein just proximal to the wrist, thereby eliminating the external shunt and enabling a high-flow system for hemodialysis. To this day, it remains the procedure of choice for patients with end-stage renal disease in need of chronic hemodialysis.


Hemodialysis Peritoneal dialysis Vascular access Surgical procedure Fistula Complications 

Supplementary material

Video 3.1

Brachiocephalic AV fistula for dialysis (Humar) (WMV 158514 kb)

Suggested Reading

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Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Department of SurgeryBeth Israel Deaconess Medical CenterBostonUSA
  2. 2.Division of TransplantationBeth Israel Deaconess Medical CenterBostonUSA

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