Kidney treatments & therapies

Ellipsys vascular access system

Less invasive, long-lasting. The Ellipsys system offers a less-invasive approach to create an arteriovenous (AV) fistula for hemodialysis.1,2

Meet the Ellipsys system.

The Ellipsys vascular access system offers a fast, nonsurgical approach to AV fistula creation, using heat to fuse the artery and vein together during a procedure that usually takes 30 minutes or less.2

What is an AV fistula?

To perform hemodialysis, the doctor needs a way to safely and repeatedly access your bloodstream. This point of access allows your blood to be cleaned by a dialysis machine and then returned to you. The most common access point for hemodialysis is an arteriovenous (AV) fistula. If your doctor recommends this option, it is important to know there are two ways to create an AV fistula.


  • The most common option
  • Connects the artery and vein with sutures during an outpatient surgery
  • Usually takes an hour or more to perform3
  • Requires an open incision that leaves a scar

Nonsurgical (Ellipsys system)

  • More recent option
  • Connects an artery and vein with heat during a minimally invasive procedure
  • Procedure usually takes 30 minutes or less2
  • Does not require an incision or sutures — only a small needle stick
  • May place less stress on the heart compared to a traditional upper-arm surgical fistula4
Illustration of an arm showing veins, arteries, and the AV fistula with numbered callouts
  1. Vein
  2. Artery
  3. AV fistula

Using the Ellipsys system, 98.4% of patients have a working fistula at three months2

Using the Ellipsys system, 92% of patients have a working fistula at five years5

This procedure is not for everyone. Please talk to your doctor to see if it is right for you. Risks may include total/partial occlusion or stenosis of the anastomosis, failure to achieve fistula maturation, Steal Syndrome, hematoma, infection, and need for vessel superficialization or other maturation assistance procedures. Although many patients benefit from the use of this device, results may vary. Your doctor should discuss all terms, potential benefits, and risks with you.

What is the Ellipsys experience like?

Getting a nonsurgical AV fistula with the Ellipsys system follows four stages.

1. Selection

A simple in-office test (ultrasound imaging) can determine if you are a good candidate for an endovascular AV fistula.

2. Creation

The minimally invasive procedure using the Ellipsys system usually takes 30 minutes or less to perform.2

3. Maturation

Follow-ups over a six-week period help establish if the AV fistula is mature enough to support hemodialysis.

4. Cannulation

Cannulation occurs when the AV fistula is ready to allow regular hemodialysis.

What happens during a procedure using the Ellipsys system?

There are six steps in the procedure:

1. Venous puncture

Illustration of Ellipsys™ system about to puncture a vein

2. Radial artery puncture

Illustration of Ellipsys™ system puncturing the radial artery vein

3. Catheter positioning and activation

Illustration of Ellipsys™ system being positioned and activated

4. Balloon inflation

Illustration of Ellipsys™ system balloon inflating

5. Fistula created

Illustration of Ellipsys™ system showing fistula creation

6. Post-op bandage

Illustration of an arm with a bandage on it

Start the conversation.

Our doctor discussion guide can help you talk about treatment options with your doctor.

Older male patient in blue shirt sitting next to a female physician in white coat as they look at a clipboard while smiling



Shahverdyan R, Beathard G, Mushtaq N, et al. Comparison of Ellipsys Percutaneous and Proximal Forearm Gracz-Type Surgical Arteriovenous Fistulas. Am J Kidney Dis. October 2021;78(4):520–529.e1.


Hull JE, Jennings WC, Cooper RI, Waheed U, Schaefer ME, Narayan R. The Pivotal Multicenter Trial of Ultrasound-Guided Percutaneous Arteriovenous Fistula Creation for Hemodialysis Access. J Vasc Interv Radiol. February 2018;29(2):149–158.e5.


Arteriovenous Fistula (AV Fistula). University of Utah Health. Available at: Accessed October 5, 2023.


Mallios A, Bourquelot P, Franco G, et al. Mid-term results of percutaneous arteriovenous fistula creation with the Ellipsys vascular access system, technical recommendations and an algorithm for maintenance. J Vasc Surg. December 2020;72(6):2097–2106.


Hull JE, Jennings WC, Cooper RI, Narayan R, Mawla N, Decker MD. Long-term results from the pivotal multicenter trial of ultrasound-guided percutaneous arteriovenous fistula creation for hemodialysis access. J Vasc Interv Radiol. October 2022;33(10):1143–1150.