• This is the first vascular access. Made it possible to treat patients with chronic kidney failure, who would need dialysis for the rest of their lives
• A way to re-enter and use blood vessel multiple times for dialysis.
• A patient's artery and vein are linked using a plastic tube outside the skin. i But they become often infected or clotted.
1966: The arteriovenous (AV) fistula was develop by Dr. Jim Cimino and Dr. James Brescia.
• An artery and a vain are connected inside the arm.
• Cause fewer infections and blood clots than the shunt
• Even today, the AV fistula, or native fistula, lasts longest and is the best access for HD.