Hemodialysis is a method for removing waste products. Vascular accessfor hemodialysis can be temporary or permanent. Complication of vascularaccess devices are a major cause of illness and death in patients undergoinghemodialysis.An increased thrombotic tendency is an important cause ofcomplications in chronic haemodialysis patients, leading to fatalcomplications like ischaemic heart disease or stroke and also to thrombosisof the vascular access. Thrombosis is associated with low access blood flowand hypercoagulability states.The clinical presentation of hypercoagulable state may be in the formof arterial or venous thrombosis.Theraputic consideration for preservation ofvascular access includes antiplatelet therapy, oral anticoagulation and lowmolecular weight heparin.