Dr. Jeff Hull, a pioneering figure in endovascular technology, discusses the innovative Ellipsys system for arteriovenous fistula creation in dialysis care. He shares the journey from conception in 2006 to its acquisition by Medtronic in 2020, highlighting the significance of mentorship and cross-discipline teamwork. Hull emphasizes the value of competition and strategic exit planning in the startup landscape. Additionally, he introduces deep vein arterialization as a novel application in treating peripheral arterial disease, showcasing the future of vascular access.