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f 1 ince its inception, hemodialysis has been bedeviled by problems of vascular access. Access, from the time of creation and through-V^^out a patient's dialysis life, consumes significant time, effort, and expense and creates much anxiety and risk for patient and family. Vascular access complications remain the single leading cause of hos-pitalization and expense for dialysis patients. Some, such as infected access sites, are potentially life threatening. It is common for an access problem to precipitate a crisis related to the end of a patient's dialysis life. Despite the advances made in hemodialysis technology, the same vascular access problems that plagued dialysis pioneers continue today to confound patient care teams.

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