What is AV fistula and graft?

The fistula is created during a surgical procedure joining one of your arteries with a vein. ( ii) Like a fistula, an AV graft is typically placed in the arm. But unlike a fistula, an AV graft is a synthetic tube used to surgically connect the artery and vein.

What is AV fistula procedure?

An AV fistula is how patients are connected to a dialysis machine. A nurse starts your dialysis treatment by inserting two needles into the AV fistula. One needle removes the blood and sends it to the machine, where it is filtered. The second needle allows the blood to be safely returned to the body.

How long does it take to recover from AV fistula surgery?

It generally takes several months for the AV fistula to heal, enlarge and develop enough for dialysis access. Once healed, you will see the thickened vein that is joined to an artery and feel a pulse in it. In the meantime, you may have dialysis treatments using a temporary venous catheter.

Is an AV graft permanent?

AV grafts can be safely used in about two weeks, as no maturation of the vessels is necessary. Grafts have a lifespan of approximately 2 to 3 years but can often last longer.

What is the most common type of AV graft conduit?

Expanded PTFE was first used as a conduit for vascular access in the late 1970’s33 and has since become the most popular graft material, despite its high incidence of occlusion, (usually due to myointimal hyperplasia at the venous end), seroma formation, high infection rates and suboptimal patency rates.

How long does AV graft surgery take?

How is the AV fistula procedure performed? A surgeon usually performs the procedure in the operating room. You receive a local anesthetic (numbing medicine) at the proposed site along with IV sedation to relax you. Discomfort is minimal and you may even fall asleep during the 1 to 2 hour-long procedure.

How soon can AV graft be used?

A patient can usually use an AV graft 2 to 3 weeks after the surgery. An AV graft is more likely than an AV fistula to have problems with infection and clotting. Repeated blood clots can block the flow of blood through the graft. However, a well-cared-for graft can last several years.

Can you drive after AV fistula surgery?

We generally advise no driving for at least three days after your surgery. How can I check my fistula is working? Remember your fistula is your lifeline for dialysis and you must know how to look after it when you are at home. Thrill is a vibrational feeling when you place your fingers on the skin over your fistula.

How to stop a bleeding AV graft/fistula?

You also have to consider protamine if the patient is coming from dialysis because they do get heparin during dialysis. Take home points: consider throwing in some figure-of-eight sutures, using gelfoam, or possibly using medication (DDAVP, protamine) to stop the bleeding from an AV graft / fistula .

What does AV graft mean?

An arteriovenous (AV) graft is a type of access used for hemodialysis. The graft is usually placed in the arm, but may be placed in the leg if necessary. An AV graft is the connection of a vein and an artery that utilizes a hollow, synthetic tube (the actual “graft”).

What are the complications of AV fistula?

The prognosis of an uncomplicated AV fistula is usually good. Post-catheterization AV fistulas are not generally life-threatening and close spontaneously. They are associated with serious complications such as high output cardiac failure with a large AV fistula, aneurysm degeneration of the artery, and limb edema.

Are AV fistulas permanent?

Fistulas are the preferred type of access because it utilizes the patient’s own vessels and does not require permanent placement of foreign materials such as those needed to create an AV graft or catheter. The AV fistula, formed by the patient’s own vessels, is less infection-prone than a catheter, is less likely than a graft to have problems with clotting and provides good blood flow that can last for decades.