I often get asked the difference between an AV graft and an AV fistula. Both are types of hemodialysis access. The A stands for artery and the V for vein. Therefore, it is some kind of connection between and artery and a vein. The hemodialysis machine needs faster flow than a vein, but not as fast as an artery.
An AV fistula is a direct connection between the patient’s artery and one of their nearby veins. This is the aboslute BEST access a patient can have because it is all their own tissue. The fistula resists clotting and infection.
An AV graft (sometimes called a bridge graft) is an indirect connection between the artery and vein, most commonly a plastic tube is used, but donated cadaver arteries or veins can also be used.
An important thing to remember is that the AV fistula or graft is the patient’s lifeline and therefore must be protected. Never take a blood pressure in the access arm or draw blood or start IV’s.
If a patient is not a good candidate for an arteriovenous fistula, an arteriovenous graft is considered. An arteriovenous graft is a piece of artificial tubing, generally made out of teflon or fabric, that is attached on one end to an artery, and on the other end to a vein. The tube is placed entirely under the skin and the tube itself is punctured during dialysis.
An arteriovenous graft can in general be used two to three weeks after the operation. However, arteriovenous grafts are more prone to infection and clotting than fistulas. The lifespan of an arteriovenous graft is approximately two to three years.