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We ask Mr Valenti what exactly Arteriovenous (AV) Grafts are.

Arteriovenous (AV) Graft

In order to have haemodialysis treatment to remove waste products and excess fluid from your body, the medical team require access to your bloodstream. An AV graft is one type of vascular access that facilitates this treatment.

Prior to the procedure your consultant will discuss the vascular access options with you. They will also carry out an ultrasound scan of the veins in your arms, to choose the best place to create the vascular access point. In some cases, a venogram may be required, this is an x-ray that uses a contrast to show how blood flows through your veins.

What is an AV graft?

An AV graft is a synthetic tube which is placed under the skin to form a bridge between an artery (blood vessel that carries blood away from your heart) and a vein (blood vessel that carries blood back toward your heart) which is usually placed in the arm, but may be placed in the leg if necessary.

This type of connection results in blood flowing from the high flow, high pressure artery through the graft and into the low flow, low pressure vein. As a result, the blood flow through the graft provides a flow rate that will deliver enough blood to provide adequate haemodialysis treatment.

This procedure is normally carried out under local anaesthetic which means your skin will be numb. In some circumstances, general anaesthetic may be considered, which means you will be asleep during the surgery.

The operation normally takes approximately one hour to complete. If you have had a local anaesthetic you should be able to go home later that day. If you have had a general anaesthetic, you will usually need to stay in hospital overnight. You should be able to return to normal activities within one to two weeks after the surgery.

Why should I have an AV graft?

The purpose of haemodialysis is to clean your blood, consequently you need to have an easily accessible site that allows dialysis needles to be inserted regularly. The AV graft method is a solution for small or weak veins that are not suitable for other types of vascular access. The great advantage of this type of vascular access procedure is that it requires less recovery time and you can start haemodialysis treatment as soon as two to four weeks after surgery.

What are the risks?

Compared to native AV fistulas which are formed using natural tissue, AV grafts are more prone to infection due to the prosthetic materials being used. However, all vascular access surgery, as with any procedure, carries a certain degree of risk including risks of bleeding, infection, graft becoming blocked, swelling around the graft and potentially reduced blood supply to the hand. Your consultant will discuss these risks with you prior to the operation. If you do experience any of these symptoms you should contact your consultant or vascular access nurse.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

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