Historical perspective on more than 60 years of hemodialysis access.

Chronic hemodialysis will likely remain the predominant renal replacement therapy for years to come and vascular access will probably continue as the Achilles heel of hemodialysis. The concept of needle puncture as part of the vascular access method is now well established. This article describes the evolution of vascular access and the AV Fistula needle technique for hemodialysis.