Question 1

av fistula, av graft, subclavian or femoral catheter, av shunt permanent or temporary, which is better?

Accepted Answer

AV fistula: Countless studies and decades of research have shown a clear advantage for patients who undergo hemodialysis through an av fistula.  The second best is an av graft and all catheter-based modalities for hemodialysis are a distant third.

Question 2

why is my av fistula ugly?

Accepted Answer

Weak Areas: Repeated trauma from the use of the needles to access for avf builds up over time. If happens to some degree in every patient but can happen more in patients who get the same areas "re-stuck" every time.  These are called pseudoaneursyms. Best practice is to rotate "sticks" (needle access) as much as possible. Some patients need to have these operated on in extreme situations.

Question 3

how long for av fistula to mature?

Accepted Answer

Many factors: There are many things which effect avf maturation. Vein size, location, and type of fistula to name a few. In the best of circumstances, expect 6-8 weeks, but many times a fistula will take longer or need additional procedures to help it mature fully.

Question 4

is an av fistula permanent or temporary?

Accepted Answer

Depends: If this is an aquifers avf from catheterization or other vascular injury it should be repaired and is temporary. If you are referring to a avf for dialysis this is relatively permanent.

Question 5

is it true that av fistula is permanent?

Accepted Answer

Need info: A surgically created fistula for dialysis is not removed unless infected. An av fistula from other sources may need repair. Why do you have an av fistula?

Question 6

can a person have an external av fistula?

Accepted Answer

Yes- not practical: It turns out that the first "fistulas" made years ago when dialysis first started were "external" fistulas. They were actually synthetic/plastic tubes connecting an artery to a vein. There were significant problems with bleeding and infections. These "external" fist las are not used today. If someone needs urgent dialysis they get a catheter. For long term dialysis either a fistula or a graft.

Question 7

can a failed av fistula be reactivated? how?

Accepted Answer

Yes: A failed av fistula can be from either clot or "stenosis".  A thrombectomy can be performed if the clot is new, a stenosis can be dilated with a balloon tipped catheter.  Unfortunately, av fistula failure commonly recurs in the same fistula and usually necessitates the creation of a new one in time.

Question 8

what does it mean for an av fistula to mature?

Accepted Answer

Growth for dialysis: A primary arterio-venous fistula ( that means where an artery and a vein have been sutured directly into each other as opposed to an interposition graft) takes some time for the vein to grow larger.The size of the vein is important because it allows  the flow requirements of dialysis.This often takes a month or two to happen.

Question 9

is it possible for a failed av fistula be reactivated?

Accepted Answer

Needssurgical eval: Clotting of the avf is the major problem facing patients on dialysis.  Generally, it needs to be evaluated and declotted rapidly to be salvaged (within 1-2 days) by a vascular surgeon or interventional radiologist.  The focus more recently is early prevention to prevent clotting from occuring through close monitoring of blood flows and pressures.

Question 10

can you tell me how the procedure for av fistula placement works?

Accepted Answer

It works well.: A fistula is the best option for long-term hemodialysis. Your own artery and vein are connected in a small surgical procedure. It takes 6 weeks or more to grow or mature and then 2 needles are inserted for dialysis. There is no artificial material as in an av graft so the fistulas stay open. See www, fistulafirst, org for more info.

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Doctor answers about:

Av shunt vs av fistula

A member asked:

Av fistula, av graft, subclavian or femoral catheter, av shunt permanent or temporary, which is better?

A member asked:

Why is my av fistula ugly?

A member asked:

How long for av fistula to mature?

A member asked:

Is an av fistula permanent or temporary?

A member asked:

Is it true that av fistula is permanent?

A member asked:

Can a person have an external av fistula?

A member asked:

Can a failed av fistula be reactivated? how?

A member asked:

What does it mean for an av fistula to mature?

A member asked:

Is it possible for a failed av fistula be reactivated?

A member asked:

Can you tell me how the procedure for av fistula placement works?

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