Advancements in Access for End-Stage Renal Disease and the Creation of Endovascular Fistulas.

The prevalence of end-stage renal disease has increased significantly since the 1980s, and the demand for successful, safe, and durable hemodialysis access is rising. Autogenous arteriovenous fistulas continue to be the gold standard modality for hemodialysis access. Biologic and synthetic grafts are used with comparable outcomes but are not without their own complications. Newer developments in hemodialysis access utilize endovascular technology, including dual catheter-based systems and thermal resistance devices, which are pushing the boundaries of fistula creation optimistically forward.