Introduction: Subspecialty of nephrology involving endovascular procedures essential for maintenance and management

of dialysis access. Vascular access (AVF, AVG, HD catheter) is proclaimed as the “lifeline” and “Achilles heel” for patients

on hemodialysis Procedures, Vein Mapping (ultrasound+ contrast injection), Balloon assisted maturation. Endovascular

coiling of accessory/collateral veins, Angioplasty of stenotic segment within or outside the conduit, Thrombectomy (declotting)

of AVF/AVG, Stent graft placement, Tunneled catheter placement, exchange and removal, Peritoneal dialysis

catheter placement, exchange and removal Pros and Cons of Interventional Nephrology

Pros: Expeditious care, Patient/physician familiarity, Smooth communication, Achieving superior

Cons: Limited training opportunities, Interventional “turf ” issues Impact of VAC on hospitalize

Impact of VAC on hospitalization & missed dialysis treatments: Retrospective analysis of vascular access-related

hospitalized days and missed outpatient dialysis treatments from 1995-2002 in 21 Phoenix dialysis facilities and 1275

Fresenius Medical Care North America (FMCNA) units within the U.S. to evaluate the impact of introduction of VAC

in Phoenix, Decline in hospitalized days and missed treatments/patient year evident from 1997-2001 across all access

types with a greater decline in Phoenix coinciding with creation of VAC in 1998 ,VAC development was associated with a

significant decrease in vascular access-related hospitalization and missed outpatient dialysis treatments