Most patients with end-stage renal disease undergo hemodialysis thrice weekly to optimize their survival, minimize medical complications, and enhance their quality of life. A reliable vascular access is a critical requirement for providing adequate hemodialysis. The ideal vascular access would be easy to place, ready to use as soon as it is placed, deliver high blood flows indefinitely, and be free of complications. None of the existing types of vascular accesses achieve this ideal. Among the three types of vascular access currently available, A-V fistulas are superior to A-V grafts, which in turn are superior to dialysis catheters. Recognizing the relative merits of the vascular access types, the NKF-DOQI guidelines recommend placement of A-V fistulas in 50% of hemodialysis patients, A-V grafts in 40%, and dialysis catheters in 10% [19]. The actual current distribution of vascular accesses among prevalent hemodialysis patients in the United States is 25-30% fistulas, 45-50% grafts, and 25% dialysis catheters [20, 21]. Vascular access procedures and their subsequent complications represent a major cause of morbidity, hospitalization and cost for chronic hemodialysis patients [22-26]. Over 20% of hospitalizations in hemodialysis patients in the United States are access-related, and the annual cost of access morbidity is close to $1 billion [25].