The AVF outcomes in terms of primary failure, patency and complication rates were significantly improved after introduction of multi-disciplinary care approach and pre-operative sonographic vascular mapping. These initiatives should be carried on and widely promoted in various hospitals with hemodialysis facilities.

Congenital intracranial tumors are rare and account for 0.5 to 1.5% of all childhood tumours. We report a case of a 3 week old baby presenting with multi compartmental congenital intracranial immature teratoma, fi rst of its kind in the literature. The child had gross total excision in two stages with aid of neuronavigation. The short term outcome was good. The four years of follow-up with serial imaging showed no tumour recurrence with a stable hydrocephalus after shunting. However, there is global developmental delay with full time dependence of care giver

Team collaboration is critical to boost up AVF use and to reduce catheter use and its related complications. This program is workable towards ‘Fistula First’ international benchmark and to strive to enhance patient’s vascular access outcomes.