Alternative variants of formation of permanent vascular access for hemodialysis

: A native arteriovenous fistula is the most preferred type of a permanent vascular access (PVA) amongst the patients on programmed haemodialysis. Complications of vascular accesses leading to their lost with time would eventually and unavoidably result in exhaustion of the vascular recourses of the patient thus creating posing a problem while forming yet another PVA. Taking into consideration vitally important necessity of carrying out haemodialysis procedures for these patients, vascular surgeons have to search for alternative variants of access to the vascular bed. According to the KDOQI guidelines, in case of full loss of suitable vessels on upper limbs, formation of PVA may be possible in the area of the femur and in the upper third of the chest, predominantly with the use of a prosthesis as a shunt. Presented in the article are different variants of PVA whose creation was dictated by impossibility of using standard approaches to treatment of such patients.