الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 184 |  |  |
| | | from | 184 | | |
Abstract
Establishing and maintaining hemodialysis access is a cornerstone of long term renal replacement therapy . Hemodialysis techniques have improved sufficiently to allow many patients to survive for as long as dialysis access can be maintained (Punch and Merion, 1995) . Since 1944 when W.J. Kolff designed the first practical dialysis machine, the search for vascular access for hemodialysis had begun and still continued until nowadays . From the beginning, the full potential of hemodialysis for the long-tenn treatment of patients with ”chronic renal failure was limited by the lack of a mean for repeated access to the vascular system . At the onset, it was necessary for repeated cutdowns to be made on an artery and vein for each dialysis, following which the vessels were ligated . The duration of a course of dialysis was therefore limited to the treatment of acute renal failure (Bennion RS et a/., 1994) . Chronic access to the circulation finally became a reality in 1960 through the combined talents of an internist, a surgeon, and an engineer . Scribner, Dillard, and Quinton introduced the Teflon-Silastic arteriovenous (A V) shunt, which brought new hope to the patient with end-stage renal disease . Their first six consecutive patients were successfully cannulated without any clotting in the external bypass that connected artery with vein. In the seventh patient, however, repeated attempts eIIJed in failure