Introduction

Abstract

The care of patients with end-stage renal disease, and particularly the management of vascular access, has evolved significantly in the last decade. Vascular access is the Achilles' heel of hemodialysis and its critical importance has become increasingly apparent. It has direct and indirect impacts on patient outcomes. Within the medical specialties of surgery, nephrology, and radiology, vascular access care has emerged as a distinct discipline of its own with increasing interest, knowledge, and technical skills that cross specialty lines. An interdisciplinary approach helps to learn more about how to optimize vascular access, leading to the development of new techniques and devices as more complex and creative solutions are required. To provide the best care for dialysis patients in a timely fashion, dedicated vascular access facilities have been developed, where vascular access committed surgeons and interventional radiologists work together closely with nephrologists. A dedicated dialysis vascular access center offers high-quality care with the lowest possible cost in a setting that is more convenient for the patients. The goal of the dedicated access center is to expedite intervention in dialysis access management, resulting in the prevention of many access-related hospitalizations and complications encountered due to missed hemodialysis treatments. It is critical to establish a vascular access surveillance program for early diagnosis and intervention to decrease the incidence of vascular access malfunctioning and prolong access longevity. Whether in a hospital setting or at a dedicated dialysis vascular access center, nephrologists, surgeons, and interventional radiologists should function as a unified hemodialysis access management team, sharing responsibilities of surveillance and treatment of malfunctioning access, with each individual contributing expertise to provide the best patient care. This issue of Techniques in Vascular and Interventional Radiology focuses on a discussion of the multidisciplinary collaborative approach, the value of free-standing outpatient facilities, and some practical approaches on management of vascular access. I would like to thank all the authors for their valuable contributions to this important issue of Techniques in Vascular and Interventional Radiology.