CURRENT METHODS OF ACCESS

What are the problems with current methods of vascular access?

Vascular access is the lifeline of the hemodialysis patient. Unfortunately, it is also the Achilles' Heel of hemodialysis. Failure rates for current access modalities are unacceptably high. Clinical studies demonstrate that approximately 30-40% of AV fistulas never become suitable for dialysis. In one recent study (DAC), 60% of AV fistulas were unsuitable for dialysis. Synthetic grafts are another option yet 50% of grafts fail within 12 months.

Access determines quality of life for hemodialysis patients

Dialysis access sites fail for many reasons. Most of these are directly affected by the quality of flow through the access site. Complications, such as those pictured below, are all too common. In addition to the impact on quality of life, CMS spends well over $1 billion per year on acces site treatment.

Recent government initiatives such as Fistula First (www.fistulafirst.org) are highlighting the poor outcomes associated with access modalities. As demonstrated in recent journal publications, acute and long-term failure rates for access procedures are among the highest of any routine surgical procedure.

RECENT CLINICAL OUTCOMES DATA
After 18 months, nearly 30% of surgically created AV fistulas were not suitable suitable for dialysis. Additionally, 60% of sites required interventions shortly after surgical placement.

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