Endovascular fistula is a long-term vascular access for patients with chronic renal failure and uremia. It is usually located in the forearm and can be palpated with obvious tremors and auscultated with vascular murmurs, and is a lifeline for hemodialysis patients. In the use of the process is prone to a number of complications and produce the corresponding symptoms, as follows: 1, endovascular thrombosis, due to the vascular anastomosis for turbulent flow, as well as puncture formation of vascular endothelial damage, coupled with some patients in a hypercoagulable state, or combined with improper operation or pressure, the local formation of thrombus, resulting in reduced flow, the formation of a short period of time can try endovascular thrombolysis, if necessary, the kidney needs to be embolization, or even Endovascular reconstruction; 2. Endovascular bleeding, which can occur after a newly established endovascular fistula as well as after dialysis extraction, first requires symptomatic management. Attention should be paid to the clarification of coagulation, adjustment of anticoagulant dosage if necessary, patient education on the method and duration of local pressure on the puncture after dialysis; 3, internal fistula pseudoaneurysm, which is mostly seen in elderly patients, where the vessel wall is fragile and easily damaged by puncture bleeding; 4, internal fistula dysplasia and infection of the skin at the mouth of the internal fistula, etc.