Vascular Access // MARC

A catheter is considered a temporary access for use while a patient awaits a permanent access. Catheters are usually placed in the neck, chest, or groin, depending on usage time.
A graft is a more permanent access consisting of a synthetic tubing placed in the arm. Grafts require replacement over time.
An AVF is a permanent access created by joining a patient's vein and artery together. AVFs are considered the longest lasting and healthiest access type.

A preponderance of medical literature exists, providing convincing evidence that the AVF is the preferred access based on low complication rates, longevity, and low costs. Therefore, in 2003, the Centers for Medicare & Medicaid Services (CMS), the ESRD Networks, and key representatives launched the National Vascular Access Improvement Initiative (NVAII). The goal was to promote and increase AVF use and exceed the National Kidney Foundation's (NKF) Disease Outcomes Quality Initiative (K-DOQI) practice guidelines.

In 2005, the goal was reached ahead of the anticipated timeline, and NVAII was recognized as a CMS national initiative. NVAII became known as the national Fistula First Breakthrough Initiative (FFBI). Today, FFBI represents a joint effort between ESRD Networks, CMS, and the renal community.

Download one of the following order forms to obtain resources to assist your facility in increasing AVF rates:

Fistula First Resources Order Form
Buttonhole Cannulation Resources Order Form

MARC also has a number of Vascular Access presentations available for facility-based education on the Presentations webpage. If you would like to use one of these presentations for an in-service training in your dialysis facility, please call MARC at 804.320.0004 or e-mail marc@nw5.esrd.net.

For additional resources, visit the FFBI website or the Network 5 Fistula First Project web page.

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Vascular Access

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Resources