DaVita.com Kidney Education http://www.davita.com DaVita provides a complete range of dialysis treatments and support services for patients living with chronic kidney failure, also known as end stage renal disease, or ESRD. Rope Ladder and Constant Site or Buttonhole Techniques http://www.davita.com/preparing-for-dialysis/planning for a vascular access/rope-ladder-and-constant-site-or-buttonhole-techniques/a/5034

To help keep a fistula healthy, there are two recommended methods of cannulation; the rope ladder technique and the buttonhole (BH) technique. Currently, the rope ladder technique is commonly used in dialysis centers, while the buttonhole technique is recommended for hemodialysis patients who self-cannulate. Learn about the ladder and buttonhole methods and which may be best for you.