Trial of a new buttonhole vascular access method involving the great saphenous vein

We usually use an AVF (arteriovenous fistula) or AVG (arteriovenous graft) for VA (vascular access) for hemodialysis. However, if we cannot use an AVF or AVG, a vascular catheter is used. However, vascular catheter use is associated with many complications, such as obstruction and infection. Therefore, it is difficult to use vascular catheters safely in the long term. Our hospital invented a new VA method, named SVBP (saphenous vein buttonhole puncture). We created SVH (saphenous vein buttonholes) in 20 patients and performed 2,687 hemodialysis sessions in these patients. SVH can be used from the day after they are created. In addition, after 1 year of continuous use none of the SVH had become blocked. Regarding VAI (vascular access‒related infections), the frequency of such infections was about one‒half of that associated with TCC (tunneled cuffed catheters) and about one‒twelfth of that associated with NCC (non‒tunneled cuffed catheters). SVH is a new surgical technique; therefore, there are many problems to be solved, such as preventing thrombosis and thromboemboli. However, SVBP has many advantages over vascular catheter use, and hence, may be a useful third VA method for use in cases in which AVF and AVG cannot be employed.