Arteriovenous graft (AV graft)

How to take care of arteriovenous graft

When the kidneys stop functioning, toxins and fluid start building up in the blood stream. Hemodialysis (also known as dialysis) replaces kidney function by filtering the blood and removing the toxins. Dialysis requires access to the blood stream. Access is formed by a surgical procedure. The 3 most common types of access are internal arteriovenous fistula (AV fistula), internal arteriovenous graft (AV graft) and central venous catheter.

AV graft for dialysis patients

The safest and most common form of access is the AV fistula, made by connecting the artery to the vein directly. If one’s own blood vessels can’t be used, artificial tubing called a graft is inserted underneath the skin of the forearm, upper arm or thigh, with one end connecting to an artery and the other to a vein in the same limb. This procedure is known as creating an internal arteriovenous graft. The graft is usually placed on the arm least used.

AV graft Common Risks

Approximately 19% of dialysis patient in the US have AV grafts. The risk of infection and thrombosis for AV grafts are 10 times higher than for AV fistulas, and rise rapidly in cases of secondary health issues such as obesity, diabetes, compromised immune function, etc. Graft site also impacts infection risk with access infection more likely to occur in thigh grafts. Additional consequences of AV graft infection include prolonged catheter dependence,  the need for multiple vascular access procedures, loss of access site, infections, sepsis, lengthy hospitalizations, infection of old non functioning AV grafts and chronic inflammation.  Grafts have a relatively short life span of approximately 2-3 years and generally additional surgery will be required.

Because of the many risks involved in AV grafts adequate care is critical. Special care must be taken in order to avoid infection: Cleaning around the graft with antibacterial soap or rubbing alcohol before dialysis, meticulousness in washing hand before and after touching graft, extreme caution with carrying weights, bumping or cutting graft arm and constant care of general health including adequate nutrition, limited salt intake, daily exercise and no smoking are crucial in arteriovenous graft care.

It is important to remember that the safest form of vascular access is the arteriovenous fistula, made even safer with the use of VasQ™, designed to regulate flow by constraining and shaping optimal geometrical parameters of the fistula and reinforce and shield the perianastomotic vein against high pressure, wall tension and flow levels. Read more about AV fistulas and the use of VasQ™.