A
hemodialysis and
vascular access system comprises a subcutaneous composite PTFE
silastic arteriovenous fistula having an indwelling
silastic venous end which is inserted percutaneously into a
vein and a PTFE arterial end which is anastomosed to an
artery. Access to a
blood stream within the
system is gained by
direct puncture of needle(s) into a needle receiving site having a tubular passage within a
metal or plastic frame and a
silicone upper surface through which needle(s) are inserted. In an alternate embodiment of the invention,
percutaneous access to a
blood stream may be gained by placing needles directly into the
system (i.e. into the PTFE arterial end). The invention also proposes an additional embodiment having an arterialized indwelling venous
catheter where blood flows from an
artery through a tube and a port into an arterial reservoir and is returned to a
vein via a port and a venous outlet tube distinct and distant from the area where the blood from the
artery enters the arterial reservoir. The site where blood is returned to the
vein is not directly fixed to the venous wall but is free floating within the vein. This system provides a
hemodialysis and
venous access graft which has superior
longevity and performance, is easier to
implant and is much more
user friendly.