Vascular Access
Vascular Access for Nephrology Patients
Written byTriantafyllos Giannakopoulos MD, PhD, FEBVS, FACSMedically reviewed: 27 July 2026
Specialized Solutions for Nephrology Patients with High Blood Flow Requirements
Vascular Access for Chronic Hemodialysis Patients
Chronic hemodialysis patients need vascular access with high blood flow for conducting renal replacement therapy sessions. This is achieved by creating (a) an arteriovenous fistula using the patient's own veins or (b) synthetic grafts when the former is not feasible.
According to current guidelines, the use of (c) permanent central venous catheters as chronic vascular access should only be done when no other option exists for type (a) or (b) arteriovenous access, because it is associated with higher mortality rates compared to arteriovenous fistulas.
Finally, with the help of medical technology, at Vascular Therapy we can safely provide solutions to patients who have no vascular access or need to be freed from their permanent central venous catheters.
Arteriovenous Fistula
Creation of a fistula using the patient's own veins for optimal blood flow. The preferred choice for long-term hemodialysis.
Synthetic Grafts
Alternative solution with synthetic grafts when a fistula is not feasible. Safe option for patients without suitable veins.
Central Catheters
Last resort when no other arteriovenous access option exists. Used only when options (a) and (b) are excluded.
Long-term Vascular Access for Nephrology and Chronic Hemodialysis Patients
Given that vascular access (fistula or graft) is punctured consistently 3 times every week, the cornerstone for the uninterrupted function of the nephrology patient's vascular access is its continuous and regular monitoring with vascular ultrasound by experienced and trained personnel.
At Vascular Therapy we responsibly undertake the regular monitoring of our nephrology patients' vascular access with detailed mapping and detection of potential stenoses as well as reliable flow measurement.
This allows us to intervene in time to avoid thrombosis (loss) of the vascular access.
Vascular Ultrasound
By experienced personnel for detecting potential stenoses
Detailed Mapping
Comprehensive imaging of the vascular access
Flow Measurement
Reliable blood flow measurement for timely intervention
Regular Monitoring
Continuous monitoring for uninterrupted function
Thrombosis Prevention
Timely intervention to avoid vascular access loss
Emergency Dysfunction Management
Even in the case where a nephrology patient's vascular access suddenly stops functioning
Fistula Thrombosis
Immediate intervention to restore arteriovenous fistula function.
Graft Thrombosis
Emergency procedure to correct the problem in the synthetic graft.
Catheter Dysfunction
Quick resolution to continue hemodialysis via central venous catheter.
Quick Return to Dialysis Sessions
We undertake the immediate correction of any problem for your safety and health. Contact us for specialized management.
Contact UsReferences
- Schmidli J, et al. Vascular Access: 2018 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 55(6):757–818 (2018) — doi.org/10.1016/j.ejvs.2018.02.001
- Lok CE, Huber TS, Lee T, et al. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis 75(4 Suppl 2):S1–S164 (2020) — doi.org/10.1053/j.ajkd.2019.12.001
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