Endovascular techniques for cannulation difficulties in dialysis access

Abstract

Although the arteriovenous fistula (AVF) is the access of choice for dialysis, its success as an access is limited by its high rate of failing to mature and its development of venous stenoses. This makes cannulation difficult or even impossible for dialysis staff. A variety of endovascular techniques exist for improving cannulation rates in AVFs. These include coil embolization of tributaries and balloon-assisted maturation in immature fistulae and fistuloplasty, stents and thrombus removal in mature failing access. This article aims to discuss the methods and evidence related to these techniques.