An innovative vascular access option for haemodialysis

Traditionally an upper limb arteriovenous fi stula (AVF) or arteriovenous graft (AVG) is the fi rst choice for vascular access for haemodialysis. For the group of patients unable to maintain a functioning access the use of a long term central venous dialysis catheter (CVDC) has been necessary. This case study describes an innovative Polytetrafl uoroethylene (PTFE) graft from the subclavian artery to the inferior vena cava for the fi rst time in a regional haemodialysis unit. This unit’s experience with the graft has been very positive. It has been easy to cannulate and has not presented any diffi culties when used three times per week for haemodialysis treatment. The patient reports being comfortable with the placement of the graft and is relieved to have been offered this option on a background of multiple failed upper arm AVF/AVG and three episodes of line sepsis. Long term CVDC can be a poor choice in relation to infection and those patients with no potential for successful access in the upper limbs can be considered for alternative access procedures. Itis likely that renal nurses will become increasingly involved in caring for haemodialysis patients that have dialysis access placed other than in the limbs.