Hemodialysis is the predominant treatment for 86.9% of patients with kidney failure, with 80% starting with a catheter. Vascular access complications significantly increase morbidity and mortality. This review highlights newer devices for minimally invasive arteriovenous fistulas (AVF) and other innovations to improve vascular access patency, including endovascular AVF techniques and bioengineered grafts.

Traditional hemodialysis vascular access methods—AVF, arteriovenous graft, and central venous catheter (CVC)—have challenges, with CVCs posing the highest risk of complications. Innovations like the Ellipsys and WavelinQ systems for endovascular AVF creation show promise in reducing surgical reliance, while bioengineered grafts like Humacyl offer new options for patients unsuitable for traditional AVF. Additionally, technologies such as early cannulation grafts and the Inside-Out Surfacer device address immediate and long-term vascular access issues. These advancements emphasize the need for continuous improvement and patient-centered approaches in dialysis care.

Reference: Vachharajani TJ, Taliercio JJ, Anvari E. New Devices and Technologies for Hemodialysis Vascular Access: A Review. Am J Kidney Dis. 2021;78(1):116-124. doi: 10.1053/j.ajkd.2020.11.027.