Planning and evaluation for vascular access in the elderly

Abstract

Vascular access is of vital importance for patients requiring dialysis therapies. AV fistulas have been endorsed by many professional societies as the access of choice, however, subsequent creation does not go without consequences. As the population ages and patients become more medically complex, access failure has become a major cause of treatment complication. For the elderly, this is especially true and there are multiple decision points that require careful reflection before an AVF is placed. This article reviews access considerations for AVF placement in the elderly population and considers the possibility that the fistula first approach to vascular access should not be an absolute.

Introduction to unresolved issues in the care of dialysis patients

“…Faull et al provide arguments for the cardiac risk posed by arteriovenous fistulae in certain patient populations. The planning and evaluation of vascular access in the elderly and those with limited lifespan are then examined by Halinski and Koncicki …”