The best way to assure successful placement of a fistula is to have vein mapping. This shows vessels that are the best to use. Here's information on vein mapping:
Most fistulas and grafts are placed in the lower arm between the bend in the elbow and the wrist. They are usually placed in the patient's non-dominant arm. The patient needs to be sure to tell the surgeon which is his/her dominant arm -- the one he/she uses to write and do most activities. If it's not possible to place the fistula or graft in the lower arm, then the surgeon usually looks at placing it in the upper arm. The next most common place is in the thigh. Catheters are the last choice of access, except for emergency access or if a patient cannot have a graft or fistula for some reason. These are placed in the upper chest.
Here are patient education resources that are recommended by the Fistula First initiative:
Here's an educational offering for physicians about vascular access placement that is part of the Fistula First initiative:
Here's information on Dr. Vo Nguyen and tips for fistula placement based on his success: