Successful haemodialysis depends upon the patient having a patent, functional vascular access. The most successful of these is the native arterio-venous fistula (AVF), with the synthetic graft running in second place and a tunneled catheter as a last choice for long term use. The evolution of dialysis access has been dependent upon the determination of a few clever people and history has seen some remarkable advances and changes.

Come on a journey which begins in the late 1800's when Jabouley and Briau first experimented with suturing an artery-end-to-end anastamosis in dogs. Follow the path and meet Alexis Carrel, who was awarded the Nobel Prize in 1912 for his work and discover the revolutionary development of the Scribner Shunt to the present day where the Cimino-Brescia AVF is still the best option. Let us also look to the future and explore the potential of dialysis ports. The journey is never ending as the development of a fullproof successful dialysis access continues.

This presentation will offer a journey through the history and evolution of the various stages and types of vascular access and how we access them with the view of enlightening colleagues of the past and what the future holds. All the time remembering that sometimes what is old becomes new again.