Friday, November 5, 2010
• The AVF is the "gold standard" for hemodialysis access
• It lasts longest and has the fewest problems, including
• The main disadvantage of an AVF is how long it can take to mature: 4-6 weeks or more.
• Some fistula also fail to mature at all, a problem called early or primary failure.
• A fistula may not mature if:
• The anastomosis is too small, so less blood flows into the fistula
• A stenosis develops at the inflow between the anastomosis and the fistula
• Side veins off of the AW (accessory veins) reduce pressure in the fistula, so it does not arterialize.
• The vessel chosen by the surgeon was too small (<2 mm)