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The Buttonhole Technique for Arteriovenous Fistula Cannulation - Download article and take CE posttest
Lynda K. Ball

The buttonhole technique began 30 years ago in Europe and Japan, and 25 years ago in Seattle, Washington. Some believe its failure to “catch on” in the United States is due to the graft culture of the last 20 years. Now with an increase of AV fistulae, this technique is becoming known as a viable cannulation option. The purpose of this article is to provide technical information for nephrology nurses performing this technique.


Lynda K. Ball  is Quality Improvement Coordinator, Northwest Renal Network, Seattle, WA; an instructor at Clover Park Technical College Hemodialysis Technician Program, Tacoma, WA; and a national speaker on cannulation. She is a member of ANNA’s Greater Puget Sound Chapter.