Arterial cannulation

I am, for almost a year and a half now, on home hemodialysis. I’m doing dialysis 5 days a week. I had no issues with the cannulation neither with the artery nor the venous access. My button holes are located on the upper arm and I had to undergo a vein transplant to a more convenient location as my vein is very deep.

About two months ago my artery button hole collapsed. The nurse at the dialysis center created a new button hole (we do not use sharp needles as we are not proficient with them). When the nurse created a new artery button, since then I have had a sharp burning pain when inserting the needle and it lasts for some time (about 15-20 minutes after starting treatment). There is also pain when removing the needle. At the venous button hole I have no feeling whatsoever when inserting the needle.

As an experiment I did not do dialysis for 3 days. The next time when I did dialysis there was far less pain than before, but the day after the pain returned in full.

I have very limited space on my upper arm where I can cannulate and create a new button hole. My question is, can I reuse the original hole that collapsed? Is there anything I can do to ease the pain?

Thank you and hope to hear from you soon,
Nathan R.

great questions explain what you mean by collapsed. How deep is your buttonhole? is there any way that you can post a picture? The pain is do to a nerve you will have to move and create a new buttonhole

I used the term “collapsed” because the nurse used it. The problem was when we cannulated the artery button hole we went into the vein but we couldn’t get any blood flow, so the nurse decided to create a new button hole about 3/8" away from the old one. From day one it was extremely painful, when with the old button hole I even didn’t feel it. The useful area that I have on my arm is very limited. The higher I go
the dipper the vein is and it’s goes under my arm. Originally when I went on dialysis when they cannulate venous


I have another question, can old button hole be reused after a time , I mean create a new button hole at the old , not used for a while old button hole.

Because we don’t have enough space on the arm. As you see from the picture we have now 3 button holes, the lower one is the old one, which stopped

working over the time (one year) the next button hole that you see we are using now as an arterial button hole and it’s for some reason very painful to use and the third one

(all away up) is venous button hole.

Thank you

yes you can use the old buttonhole track but, use touch cannualtion so the needle travels down the old track

Loide haver not heard back from you how is it going?