How many patients really need long needles? We have several patients in our facilities that have come to use 1 1/4 inch needles routinely.

Are they more likely or less likely to cause long term problems?

Are they using long needles due to a deeply implanted graft (or just a large amount of tissue/fat/edema around the access)? If the graft is so deep that the needle can not be advanced and the wings leveled out- then the 1 1/4" needles are appropriate. If the longer needles were needed when the access site was still edematous and is now down- then try the 1". The risk of using too long of needles could be damage to the graft wall or by the staff inserting the needles with the same technique used for the shorter needles and they push too much needle into the graft and into the back wall before leveling out and advancing the needle. I have never use an 1 1/4" needle on a AV fistula. Just never seen one implanted that deep- even in the upper arm.