Thrill seekers? You may be thinking of base jumping off the Macau Tower at 200 kilometers per hour or perhaps running with the bulls in Pamplona. This issue isn't about any of that, and the “thrill” we seek is the smooth vibration of a nicely flowing hemodialysis access circuit. Dull? Never!

Within this issue, there are a series of bold approaches toward creation and maintenance of hemodialysis access. Think that surgery is the only way to make an arteriovenous fistula? Read Drs. Dheeraj Rajan and William Cohn's article about percutaneous arteriovenous fistula creation in humans.

Are you using conventional angioplasty during arteriovenous intervention? Dr. Rupert Horst Portugaller reports on the early European experience with drug-eluting balloons. Is your patient living with a thigh AV access or tunneled catheter? Maybe an “inside-out” venous recanalization can move things back to the arm or chest. Dr. Tom Vesely explores the challenges of catheter design, while Dr. Michael Tal and colleagues report on the optimal technical aspects of catheter placement.

Are dialysis grafts rendered obsolete by the Fistula First Initiative? Drs. Nicolas L'Heureux and Todd McAllister report on exciting advances in cell-based arteriovenous vascular conduit development that may reduce complications and costs.

How about some of the exciting shifts in dialysis access management, surveillance, and training? Dr. Aris Urbanes shares his thoughts on the future of outpatient vascular access centers, and Dr. Jack Work explains whether dialysis access surveillance is worthwhile or not.

And finally, what happens when the thrill is gone? Our esteemed panel of experts (including Drs. Abigail Falk, Scott Trerotola, and Karim Valji) discuss their various approaches to treating the clotted hemodialysis access.

It's been my pleasure to work with this terrific group of contributing authors in my role as Guest Chief Editor of Endovascular Today's annual dialysis access issue. I hope you'll agree that this issue is bold and stimulating. As for the thrill of dialysis access … it should be palpable when your work is done. If not, consider a trip to Macau or Pamplona.