The majority of AVF created does not meet the "Rule of 6s" which makes it difficult to cannulate. And many AVF have prominent bruit and thrill but veins are present deep which makes it difficult to find the vein and cannulate which if not done properly might lead to access-related complications. Because of these reasons the patient has to go back for Central Venous Catheter (CVC) or Arteriovenous Graft (AVG) as their vascular access which is higher in cost and less preferred for maintenance hemodialysis due to its high complication rate compared with AVF. To avoid patients settling with CVC/AVG there are many techniques and procedure which helps make difficult cannulation easy.