In patients with end stage renal disease (ESRD), the ideal venous access for hemodialysis should fulfill three requirements: 1. indefinite life, 2. high flow, 3. no complications such as thrombosis or aneurysm formation. The native arteriovenous (AV) fistula comes closest to fulfilling these requirements and is the best option for venous access.
In planning for creation of an AV fistula several factors have to be taken into considerations including the patient's vascular history. Patients who have had prior central venous catheters, pacemakers may be poor candidates for AV fistula creation because these procedures are associated with venous stenosis.
Patel AA, Tuite CM, and Trerotola SO. K/DOQI guidelines: what should an interventionalist know? Semin Intervent Radiol 2004;21(2):119-24.