Single needle vascular access systems, devices and methods for use in hemodialysis and apheresis procedures the device includes a multi-layer dilator. A single needle vascular access device includes a body having a venous and arterial passage with both in fluid communication with a vascular dilator. A cannulation needle is guided through the arterial passage and vascular dilator to cannulate a graft or fistula. Following cannulation, the dilator is gently introduced into the vessel. The cannulation needle is removed, and a venous tube is introduced through the venous passageway through the vascular dilator and into the fistula or graft. Blood is then removed from the body through the vascular dilator side orifices and returned through the venous line.
