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The Vascutek cannulation guidelines are provided to assist dialysis units with their in-house training. The guidelines are intended for individuals to use as a reference document. Vascutek appreciates that different facilities will have their own protocol for the initiation of dialysis.

This information serves only as guidance in technique and in no way constitutes a prescriptive instruction for use for any Vascutek ePTFE vascular prosthesis used for the purpose of vascular access.

The guidelines are also available in presentation format for larger audiences.

Selection of Cannulation Site

Guiding Principles

  • Venous and arterial bevels should be at least 5 cm apart
  • Do not cannulate within 2.5 cm of an anastomosis or reinforcement
  • Selected sites should be between 0.6 and 1.25 cm from previous sites
  • Rotate sites at each session

There are specific areas that must NOT be cannulated. These are different for each graft configuration.

Guidelines to cannulation and needle rotation are outlined below.

Straight graft

  • Do NOT cannulate within 2.5 cm of anastomosis
  • Start in central position and rotate sites outward
  • When stick point is within 2.5 cm of anastomosis, return to central position

Cannulation Area - straight graft

Loop Graft

  • Do NOT cannulate within 2.5 cm of anastomosis
  • Mark the central position of the graft loop
  • Do not cannulate on curved tight-looped section
  • Note: Rapidax™ can be cannulated in this section
  • Allocate one side exclusively for arterial sites
  • Allocate one side exclusively for venous sites
  • When stick point is within 2.5 cm of anastomosis, return to central position

Figure 2. Cannulation Area - Loop Graft

Loop Graft (with Central Reinforcement)

  • Do NOT cannulate within 2.5 cm of anastomosis
  • Mark the central position of the graft loop
  • Do not cannulate on curved tight-looped section or within 2.5 cm of reinforcement
  • Allocate one side exclusively for arterial sites
  • Allocate one side exclusively for venous sites
  • When stick point is within 2.5 cm of anastomosis, return to central position

Figure 3. Cannulation Area - Loop Graft

Tapered Graft Loop Configuration

  • Do NOT cannulate within 2.5 cm of anastomosis
  • Cannulate only on wide bore section of graft
  • Mark the central position of the graft loop
  • Do not cannulate on curved tight-looped section
  • Allocate one side exclusively for arterial sites
  • Allocate one side exclusively for venous sites
  • When stick point is within 2.5 cm of anastomosis, return to central position

Figure 4. Cannulation Area - Tapered Loop Graft Configuration

Tapered Graft Loop Configuration (with Central Reinforcement)

  • Do NOT cannulate within 2.5 cm of anastomosis
  • Cannulate only on wide bore section of graft
  • Mark the central position of the graft loop
  • Do not cannulate on curved tight-looped section or within 2.5 cm of reinforcement
  • Allocate one side exclusively for arterial sites
  • Allocate one side exclusively for venous sites
  • When stick point is within 2.5 cm of anastomosis, return to central position

Figure 5. Cannulation Area - Tapered Loop Graft Configuration (Central Reinforcements)

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