05 Feb THE BUTTONHOLE METHOD FOR THE CANNULATION OF ARTERIOVENOUS FISTULAS
The survival of a native arteriovenous fistula (AVF) not only depends on the vessels chosen and the technique used, but also on the method of cannulation.
However, there is no generally effective method for the various types of AVFs.
Each dialysis centre should adopt its own puncture protocol.
In the proposed Guidelines for Vascular Access for Haemodialysis, one of the puncture techniques we refer to is the so-called “Buttonhole” method, i.e. the continuous puncturing of a skin site to form a precise subcutaneous path.
The advantage of this technique is that it causes less pain and accurately identifies the best location for introducing the needle, even for the nurse who occasionally inserts it.
The limitations to this technique are closely related to the experience of the dialysis centre. The advantages include the reduced number of complications such as haematoma, stenosis, infections and pseudoaneurysms and causing less pain for the patient.
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