Abstract: It is essential for a guidewire to arrive at the target vessel and cross the lesion during ultrasound-guided percutaneous angioplasty for arteriovenous access.The different design and materials of guidewire determines their performances.So understanding of them will help you make wise choose of guidewires based on lesion features.It is important to master some techniques to make a guidewire cross the stenosis.For venous outflow stenosis,choosing appropriate technique according to the nature of the lesion is important.For juxta-anastomotic stenosis,you can try matching the guide wire and guide catheter,looping guide wire,and blocking a distal artery,etc.Relay technique is often used in the endovascular treatment of double access.These techniques above can help the guide wire cross through the stenosis quickly and safely.This article will popularize the performance,principles of guidewire use,common pathological changes of arteriovenous access and tips of guidewire cross.