DIALYSIS ACESS SURGERIES (AV FISTULA OR AV GRAFT)

AV fistula is created for hemodialysis.  An AV fistula is a surgical connection made between an artery and a vein created by CTVS surgeon, urologist or an isolated vascular surgeon. An AV fistula is typically created in upper limbs but , if necessary it can be made in the lower.  In AV fistula, blood flows from the artery directly into the vein, increasing the blood pressure and amount of blood flow through the vein.   The increased flow and pressure causes the veins to enlarge and become as thick as artery (arterialization of the vein). The enlarged veins thus is  capable of delivering the amount of blood flow necessary to provide an adequate hemodialysis treatment. AV fistulae are the preferred vascular access for long-term dialysis because they last longer than any other dialysis access. infection and clotting chances are less

AV graft is indicated when natural native superficial vein is not appropriate for AV fistula. Here an artificial graft usually a PTFE vascular graft is used to make a connection between the artery and the vein. Other procedure for better durability and using natural conduits are- Basilic Vein Transposition or Vein transfer operation for dialysis access surgery.