Autogenous arteriovenous fistulas for haemodialysis: a review.

The last 40 years has witnessed revolutionary changes in vascular access provision for haemodialysis. Autogenous arteriovenous (AV) fistula is the best access modality and should be considered first when planning vascular access. Education is required to ensure preservation of the cephalic veins in patients at potential risk for the development of end stage renal disease (ESRD). The best access procedure should be performed first and the AV fistula allowed to mature before use. Autogenous AV fistula have a cumulative patency of 85-90% and 60-85% at 1 and 3 years respectively. Increased use of preoperative imaging and the use of autogenous vein are essential to improved long-term results.