Vascular Access for Dialysis, Chemotherapy, and Nutritional Support

The success of many modern medical therapies is intimately tied to the success of vascular access. Hemodialysis for renal failure, chemotherapy for cancer, hyperalimentation for nutritional support, plasmapheresis for autoimmune disease, central pressure monitoring for the patient in intensive care, and blood replacement for the trauma victim are examples of therapies that depend on effective and reliable vascular access. The importance of angioaccess is so great that entire monographs have been written on vascular access in general,1 catheter access to the central veins,2 and vascular access specifically for dialysis,3 chemotherapy,4 and nutritional support.5 The evolution of vascular access has a long and interesting but somewhat disjointed history.