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The technique of inserting a needle into a vascular access to establish blood flow for hemodialysis, requiring specialized skills to prevent complications and preserve access longevity.
Cannulation is the process of inserting two needles (arterial and venous) into a hemodialysis vascular access. The primary techniques are: (1) Rope-ladder (rotating site) — puncture sites rotated systematically along the length of the access, each 0.5-1 cm apart, allowing uniform healing and reduced aneurysm risk; (2) Buttonhole (constant site) — same puncture site, same angle, same depth each session, using blunt needles after track formation (6-12 insertions). KDOQI 2019 recommends rope-ladder as the standard technique, with buttonhole reserved for self-cannulating patients. Needle gauge selection: 15-16G for AVF, 17G for new AVF/AVG. Needle tip position is verified by aspiration (blood return) and absence of infiltration. Infiltration occurs in 3-12% of cannulations and requires immediate removal, cold compress, and rescheduling access evaluation.
The surgical connection created to allow blood to flow between the patient's circulatory system and the dialysis machine during hemodialysis sessions.
A surgical connection between an artery and a vein, typically in the forearm, created to provide reliable vascular access for hemodialysis.
A synthetic tube surgically implanted to connect an artery to a vein for hemodialysis access when native vessels are unsuitable for AV fistula creation.
A medical procedure that filters waste products, excess fluids, and toxins from the blood using a dialysis machine when the kidneys can no longer perform this function adequately.
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This content is a general reference, not medical advice, a diagnosis, or a treatment plan. Do not change your diet, fluids, medicines, or dialysis plan without your nephrologist or renal dietitian. Individual recommendations depend on your labs, medications, conditions, and care plan.