Differences Between AV Graft & Fistula: Advantages & Disadvantages

When kidney function is compromised there is a need for dialysis treatments in order to filter the toxins from the blood. Dialysis requires access to the blood stream, gained by placing 2 needles in the vein – one drawing blood to the dialysis machine, and the other returning the filtered blood to the blood stream. Untreated veins cannot withstand repeated needle insertions and it is necessary to create safe, long term vascular access.

There are two types of vascular access designed for long term use: arteriovenous fistula (AF fistula) and arteriovenous graft (AV graft). A venous catheters is another form of vascular access, recommended for short term use because of high risk of infection.  

The differences between AV fistula and AV graft

An AV fistula is created by directly connecting an artery to a vein, usually in the wrist, forearm or upper arm. The AV fistula causes extra pressure by increasing the blood flow into the vein, making it grow larger and stronger and providing easy access to the blood vessels.
The AV graft consists of synthetic tube implanted under the skin, connecting between the artery and the vein, and providing needle placement access for dialysis.

Advantages and disadvantages of AV fistula

PROS
The AV fistula is considered to be the best choice for vascular access.
– An AV fistula uses your own arteries and veins without the need for artificial material.
– AV fistulas provide good blood flow for dialysis, increasing the effectiveness and reducing treatment time.
– The risk of clotting or infection is significantly lower than with other forms of vascular accesses.
– AV fistulas are often a solution for people who are thought to have exhausted permanent access sites.
– AV fistula surgery is usually done on an outpatient basis, under local anesthetic, allowing for a rapid and easy recovery.
– AV fistulas last years longer than other forms of vascular access and can last for decades.
– AV fistulas are less expensive to maintain then AV Grafts or Venus catheters.

CONS
– The AV fistula requires several weeks to months to mature before it can be used.
– People with acute renal failure may need temporary vascular access until fistula is strong enough for cannulation.
– AV fistulas may not be suitable for people with small or weak veins.
– The most common problem with the AV fistula is stenosis, the narrowing of the blood vessel, which may lead to a decrease in blood flow or formation of blood clots.
– Strengthening the AV fistula requires daily exercises.
– Some AV fistulas fail to mature and process must be repeated.
– AV Fistulas are visible on the forearm.

Advantages and disadvantages of AV graft

PROS
– The AV graft provides a solution for small or weak veins.
– The AV graft can be used as soon as 2-4 weeks after placement.
– AV graft surgery is usually done on an outpatient basis, under local anesthetic, allowing for a rapid and easy recovery.

CONS
– Use of synthetic material in the body.
– With AV graft there is an increased risk of blood clotting, aneurysms and infections.
– Repeated blood clots can block the flow of blood through the graft.
– AV graft tends to close more quickly than the fistula.
– AV graft needs constant attention and upkeep.
– AV graft does not last as long as a fistula and will probably need to be replaced eventually.

AV fistula is considered the most preferred vascular access method for dialysis treatment. Although AV graft offers an alternative to fistula for patients with small or weak veins, it increases the risk of blood clotting, aneurysms and infections. Read more about Laminate Medical Technologies solution for AV fistula failure.