Although hemodialysis catheters placed in the large veins of the neck can give effective dialysis, in the long-run most patients are evaluated for placement of a more permanent method of hemodialysis. This usually involves creating a connection between an artery and a vein somewhere in the arm. Sometimes, a small arm artery is connected directly to a vein just underneath the skin. Over time this vein becomes very dilated and has rapid flow in it. Once this occurs, two small needles can be placed into this vein and they can be connected to a hemodialysis machine.
Some patients have few satisfactory veins.
In this case, a plastic tube can be tunneled just underneath the skin. The ends of this tube are surgically connected to an artery and a vein somewhere in the arm. Grafts Hemodialysis fistulas and hemodialysis grafts are created in the operating room by a vascular surgeon. These fistulas and grafts can be expected to last months to years. This reliable hemodialysis access will be used as long as there is good flow.