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Registration open 11th Cologne Dialysis Access Symposium 16–17 December 2026 · University Hospital Cologne Hands-on workshops · Lectures · Held in German Programme & registration →

Vascular Access Surgery

Vascular
Access Talk

An independent professional blog on dialysis vascular access, surgical and endovascular techniques, complications, and clinical decision-making — sharing insights from over 20 years of experience in vascular access surgery.

All content reflects solely the personal opinion and experience of the author and does not represent an official statement of any institution.

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11Articles
9Topics
20+20+ Years Experience

Articles

Latest Articles

Vascular access surgery – from creation to revision.

01

Stenosis & Thrombosis

When There Is No Way In

The inside-out technique for central venous occlusion: how it works, which patients it is suitable for, and where its limits are.

02

General

Is an Immature Fistula Better Than None?

A US registry study of more than 214,000 patients shows that even a fistula that is not yet mature is associated with better survival than a catheter alone. The message is clear: activate the patient, don’t wait, and start the teamwork early.

03

Steal Syndrome

Is DRIL Dead? Hand Ischaemia Needs a Strategy, Not a Single Operation

At CiDA 2026, a debate asked whether DRIL is dead. With still no randomized trials comparing DRIL and PAI, the more relevant question may be a different one: what exactly is causing the hand ischaemia, and do we choose our surgical strategy accordingly?

04

AV Fistula

Some Thoughts on Anastomotic Geometry

A recent randomized trial found no difference in early maturation of radiocephalic fistulas with or without distal vein ligation. But perhaps the more important question lies elsewhere: what role does the geometry of the anastomosis and its venous outflow play?

05

AV Fistula

Pediatric Vascular Access Surgery: How Small Is Too Small?

Clinical challenges, surgical decision-making, and experience from Cologne. Pediatric vascular access surgery remains one of the most demanding areas of dialysis access care. Small vessels, complex anatomy, prolonged maturation, and the prospect of kidney transplantation make every surgical decision particularly important.

06

AV Fistula

Patency Is Not Function: Are We Measuring the Right Outcomes?

Reading current publications on vascular access, I still see the same endpoints far too often: primary and secondary patency. They are established, easy to compare and fit neatly into Kaplan–Meier curves. But do they really tell us whether an access does its job?

07

Stenosis & Thrombosis

Avoiding Basilic Vein Transposition: An Individualized Endovascular Approach

Can an endovascular intervention avoid an additional access operation? Managing dialysis access in elderly patients often presents particular challenges. Beyond long-term access function, the burden of additional procedures, individual vascular anatomy and the timely availability of a usable cannulation segment all play an important role. The following case illustrates how targeted endovascular treatment enabled the use of an existing dialysis access without immediately resorting to a more extensive surgical revision.

08

General

Vascular Access Notes | 26 October 2026

Research Watch & Upcoming Meetings. The past few weeks have brought several interesting developments in dialysis vascular access. Two presentations at ASN Kidney Week deserve particular attention, while a number of upcoming meetings will provide opportunities for further scientific exchange.

09

General

11th Cologne Dialysis Access Symposium – Save the Date!

The 11th Cologne Dialysis Vascular Access Symposium will take place on December 17, 2026, at University Hospital Cologne, once again bringing together vascular surgery, nephrology and interventional medicine. The symposium will focus on current developments, challenging clinical scenarios and interdisciplinary exchange in dialysis vascular access. A practical workshop is planned for December 16, 2026.

10

General

In Memoriam Dr Klaus Konner

Remembering a Dear Friend, Teacher, Pioneer and Remarkable Human Being. Dr Klaus Konner was one of the defining figures in modern vascular access medicine, combining outstanding clinical experience with scientific rigor and a deeply patient-centred approach. His publications, teaching and international work shaped generations of nephrologists, surgeons and interventionalists. For me personally, however, he was first and foremost a dear friend. I will remember him with deep gratitude as a friend, teacher, pioneer and remarkable human being.

11

General

Why Vascular Access Talk Exists

A personal blog needs a personal explanation. Why I created this site — and who it is for.

Overview

Topics

Dialysis access surgery – all aspects from placement to long-term care.



    Dr. V. Matoussevitch

    © MedizinFotoKöln

    Dr. V. Matoussevitch

    Welcome! I am Dr. V. Matoussevitch, a vascular surgeon with a particular passion for dialysis access surgery — from the creation of the first AV fistula to complex revision procedures. With this blog, I would like to share practical expertise, clinical experience, and personal reflections, while encouraging dialogue between surgeons, nephrologists, patients, and everyone involved in dialysis access care.

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