This episode brings more logic to dialysis access lore by questioning what we do out of habit versus what the evidence actually supports, helping sharpen how clinicians think about dialysis access.

00:24 Exercise and Fistula Care

03:30 Catheter Tip Preferences

06:52 Catheter French Sizing

07:32 Right Atrial Placement

08:02 Catheter Placement Strategies

09:12 The Forceful Flush

10:23 Site Selections

11:40 Managing Catheter Dysfunction

12:25 IVC Tip Placement

14:33 Below the Diaphragm

18:16 Patient-Centric Approaches to Fistula Management

20:39 Central Lesions

22:39 Access with CIEDs

25:26 Stenting and Central Occlusions

This episode is a masterclass in dialysis access—from HeRO graft myths to fistula revisions, steal risk, and the value of a truly multidisciplinary center. Dr. John Ross brings decades of surgical experience and practical insight that every access team can learn from.

00:17 The Dialysis Access Institute

03:24 Revising a Fistula with PTFE

06:59 Catheter-Free Approaches in Access Revision

07:31 HeRO Grafts and Their Indications

10:02 The HeRO Connector

14:40 The Abandoned HeRO

16:12 One-Stage vs. Two-Stage Basilic Fistula Procedures

20:31 Assessing Risk for Steal Syndrome

23:25 After Thoughts

Dr. Stephen Hohmann joins us to offer a surgeon’s perspective and continue the conversation from the prior episode.

Hosted by:

Monnie Wasse, MD, MPH, Chicago, IL

Neghae Mawla, MD, Dallas, TX

00:00 Introductions

01:14 Challenges in Access and Tunneling Techniques

06:16 Creating New Arterial Anastomosis

09:26 Graft Length and Angles in Anastomosis

12:36 The Median Nerve

13:13 Understanding Graft Selection and Use

15:13 Early Cannulation Grafts: Pros and Cons

20:05 Managing Early Failures

23:13 Building Effective Partnerships in Patient Care

25:00 Securing Tunnelled Catheters

This episode shares practical advice for surgeons involved in dialysis access creation and maintenance; highlighting nuances in graft tunneling, positioning, and revision strategies to improve long-term outcomes for patients.

00:15 Messages for Surgeons

01:15 AV Graft Tunneling: Importance of Depth and Technique

05:28 Graft Length and Cannulation: Best Practices

07:25 Anastomosis Preferences: Optimal Angles for Access

09:29 Advice to New Access Surgeons

11:18 Positioning of Grafts: Patient Comfort and Access

18:36 Lymph Node Dissections: Access Considerations

19:36 Converting Fistulas to Grafts: No Stumps

22:36 Conclusion and Future Topics

Hosted by:

Monnie Wasse, MD, MPH, Chicago, IL

Neghae Mawla, MD, Dallas, TX

The conversation covers the management of hypotensive patients in dialysis, including access options, pharmacologic therapies, and considerations for peritoneal dialysis.

Chapters

00:00 Introduction and Swatches

01:17 Dialysis Access in Hypotensive Patients

04:37 Pharmacologic Therapies

09:27 Permanent Catheters

12:02 Transplant Considerations

13:04 Peritoneal Dialysis

14:34 HeRO Grafts

17:30 Ejection Fraction

20:06 Medication Management in Dialysis Patients

Hosted by:

Monnie Wasse, MD, MPH, Chicago, IL

Neghae Mawla, MD, Dallas, TX

This episode discusses the fundamentals of dialysis access care, including the dialysis circuit and the importance of communication and collaboration between healthcare professionals.

00:00 Introduction to Dialysis for Non-Nephrologists

02:01 Dialysis Circuit

03:24 Arterial and Venous Pressures

06:18 Prolonged Bleeding

08:41 Needles Sizes and Their Impact on Dialysis

13:04 Dialysis Adequacy

15:01 Skin Integrity and Its Importance in Access

19:00 Key Takeaways for Nephrologists and Dialysis Clinics

20:06 Collaboration Between Surgeons and Interventionalists

21:04 Empowering Patients in Their Care

Hosted by:

Monnie Wasse, MD, MPH, Chicago, IL

Neghae Mawla, MD, Dallas, TX