AV Fistula Creation
Fistula Maturation Determination & Procedures
Once the fistula is created, it will gradually increase in size over several weeks. Maturation is the term used to describe the changes in the vein that enable the patient’s fistula to be used for dialysis. The doctor will monitor the fistula maturation and perform additional procedures if necessary to determine when it is ready for dialysis.
AV Graft Creation
An arteriovenous (AV) graft is a type of access that 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. One end of the tube is connected to an artery and the other end of the tube is connected to a vein. As a result, the blood flow through the graft provides a flow rate that will deliver enough blood to provide an adequate hemodialysis treatment.
Vascular Access Repair & Maintenance Procedures
The following procedures are done in the vascular center to maintain optimal access function when an indication for evaluation is detected:
Angiogram – A picture of the inside of the fistula or graft using x-rays. A local anesthetic is used. A small needle is inserted and dye is injected while x-ray pictures are observed to identify whether an additional procedure is needed.
Angioplasty – Performed if a stenosis was observed on the angiogram. A local anesthetic and possibly IV sedation are used. A small catheter with a balloon at the tip is inserted and inflated to stretch the narrowed area. The balloon is removed at the end of the procedure. Sometimes a stent (a metal piece of mesh) is needed to support the vessel walls to keep the access open. The stent will remain inside the fistula or graft and does not move
Thrombectomy – A procedure performed to restore blood flow to a clotted access. A local anesthetic and IV sedation are usually used. The physician may use medications or devices to break up clots and to sweep and suction the clots away.