Hemodialysis Fistula Interventions: Diagnostic and Treatment Challenges and Technical Considerations

End-stage renal disease is one of the main epidemiologic health problems and dialysis access continues to be the Achilles' heel of its treatment. Consequently, hemodialysis fistula maintenance is of great importance which can best be accomplished by close collaboration between primary care, nephrology, surgery and interventional radiology services, routine access monitoring as well as early intervention in cases of impending access failure. Also, knowledge and application of specific interventional techniques that are additionally described in this article may increase intervention efficiency, decrease the incidence of complications and overcome technical challenges thus improving procedural outcome and maximizing access patency rates.