For hemodialysis, blood is taken out of the body, passed through a filter to clean it and then returned to the body. This requires an access which can be used to remove and return blood into the body safely.
An arteriovenous (AV) fistula
is the best means of access to the blood stream for long-term haemodialysis.
is the best means of access to the blood stream for long-term haemodialysis.
An arteriovenous fistula is surgically created by joining an artery to a vein. The blood vessels of the arm are chosen, either at the wrist or the elbow usually in the non-dominant arm. The blood from the artery goes straight into the vein, resulting in dilatation of the vein due to high arterial pressure, which then becomes bigger and firmer. This makes it possible to cannulate the vein for haemodialysis. The risk of infection is least. Very rarely, synthetic graft may be used to create the fistula.
An alternative to having an arteriovenous fistula is to have a temporary or permanent dialysis catheter. A dialysis catheter is inserted into one of the major veins in the neck or groin. The tube has two tubes joined together and blood can be taken out and returned after treatment using the same tube. It may be used as a temporary option when patient presents in an emergency or while a fistula is maturing. The major risk is infection, which can be potentially severe and life threatening. A tunneled dialysis catheter may be suitable for patients with multiple failed AV fistula.
Please consult your doctor for the best access suited for you.
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