Autogenous options in secondary and tertiary access for haemodialysis.

OBJECTIVES

The world's haemodialysis population is growing rapidly so that in 2006, some 1.5 million interventions will be needed for access placement, revision and maintainance. Secondary and tertiary arteriovenous fistulas are becoming an integral part of vascular access especially in the elderly, comorbid population.

METHODS

Venous conduits may have a more favourable outcome with fewer complications and revisions in comparison with accesses using prosthetic implants. Innovative surgical techniques, including vein transposition, translocation and elevation may add to this philosophy of creating exclusively autogenous vascular access.