Management of Dialysis Access, Fistula and Grafts

MANAGEMENT OF DIALYSIS ACCESS, FISTULA AND GRAFTS

If the kidneys are not working properly, dialysis is required. The blood must be purified as well as possible. Good, safe and an effective access to the bloodstream is then important.

The vascular surgeon makes such an optimal access by connecting an own vein in the patient’s arm to an artery (AV fistula or body shunt) or by connecting the vein and artery with a plastic vascular prosthesis (plastic shunt). This operation takes about an hour.

The vascular surgeon can apply a shunt:

• In the forearm. This is called a radial shunt or radiocephalica shunt.
• On the inside of the elbow or in the upper arm. This is called a brachial fistula, also known as a brachial shunt or brachiobasilica shunt.
• In the thigh. This is called a femoral shunt. This is however rarely used.