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AV Fistula/Graft Management

Arteriovenous (AV) fistulas and grafts are connections made between an artery and a vein to create an easy access pathway for dialysis treatment through improved blood flow. Using a thin needle or catheter, the new vessel can be accessed through the arm.

A fistula is the connection made between an artery and a vein under the skin. This procedure lowers the risk of infection and clotting. The increase of blood flow also improves treatment time and kidney function.

A graft, like a fistula, involves the connection of an artery and a vein, but in this procedure, a small plastic tube is used to join the two together. This method is commonly used for patients who will be on dialysis long term or have smaller, weak veins.

How to Prepare for AV Fistula/Graft Management

  • Plan to arrive an hour before the procedures, as blood test may be performed.
  • Your interventional radiologist will use venography to get images of the veins.

What to Expect

  • These procedures take approximately 1 hour.
  • You are given mild sedation to relax you and control any pain, as you will be conscious during the procedure.
  • A small incision is made in the forearm, allowing your interventional radiologist to access the vein and artery.
  • If the veins or arteries are narrow or clogged, your interventional radiologist will perform an angioplasty, during which a small tube (catheter) with a balloon attached is inserted into the narrow vessel, and the balloon inflates to open up the passageway.
  • Your interventional radiologist may also place a stent, a small mesh cage that holds up the walls of weakened arteries and veins.
  • For a fistula, the vein and artery are surgically connected.
  • For a graft, a small plastic tube is inserted into the incision, and is connected between the artery and the vein.
  • The area of incision is bandaged.

What to Expect after AV Fistula/Graft Management

  • Your interventional radiologist will monitor your recovery for 30 minutes, after which you can return to normal activities.
  • An AV fistula takes 3-6 months before it has matured and can be used. A graft requires 2-6 weeks before usage.
  • If you experience reoccurring problems, your interventional radiologist will schedule a check-up 3 months after the procedure. All other treatment and management will be handled by a nephrologist.

For More Information

For more information on AV fistulas and grafts, or to schedule an appointment with an interventional radiologist, please call 847.570.2160.