THE HISTORY OF VASCULAR ACCESS

Vascular access has been used medically for centuries. The history of access includes the ancient practise of venesection or phlebotomy, and its complications; recognition of the circulation of the blood; the f irst attempts at blood transfusion by Richard Lower; the description o f traumatic A-V fistulae by William Hunter; and the development of vas cular surgery. After the introduction of haemodialysis, the cornerston e of vascular access remains the primary direct internal A-V fistula a s described by Brescia et al. in 1966. Modem vascular grafts achieve s uitable access with increased rates of complications and failure; and, less than half the longevity of fistulae.