Central Venous Access (CVA) has progressively emerged as a viable alternative to conventional direct access methodsin the domain of fistula thrombectomy. This access methodology offers a potential alternative to direct fistula andgraft puncture, enhancing the procedural dynamics and possibly mitigating some associated complications and devicelimitations. The ensuing article explores the possible advantages and alternative applications of employing CentralVenous Access in fistula thrombectomy procedures. The deliberation underscores the criticality of access site selection,the ensuing flow dynamics, possible implications on infection rates, and the opportunistic utilization of larger borethrombectomy devices.