Your kidneys help remove waste and excess fluid from your blood, keep safe levels of minerals in your blood, and even help regulate your blood pressure. So when your kidneys fail, your body needs a little help. That’s where dialysis comes into the picture, filtering your blood.
If you’re undergoing dialysis, you need reliable and efficient vein access for regular treatments. Two of the most common options for long-term dialysis access are arteriovenous (AV) fistulas and arteriovenous (AV) grafts.
Understanding the differences between these two options can help you make informed decisions about the best access choice. Our providers at Vascular Specialists can walk you through all of the options and recommend the right type of dialysis access for your needs.
An estimated 66% of the 661,000 Americans with kidney failure require hemodialysis. To make this process more efficient, you need a point of access for the dialysis needles.
At the beginning of a hemodialysis session, your technician inserts two needles into your vascular access. One needle draws blood from your body to the dialyzer, where it’s filtered, while the other returns the cleaned blood to your body.
A fistula refers to a tube-like connection between two parts of your body that aren’t normally connected. In the case of an AV fistula, our team makes a surgical connection between an artery and a vein, usually in your forearm or upper arm.
This connection increases blood flow through the vein and allows it to strengthen and enlarge over time. This makes it easier to insert dialysis needles.
At Vascular Specialists, our team uses the Ellipsys™ vascular access system, an FDA-approved option for dialysis access, to create a fistula in less than 20 minutes. Many other AV fistulas can take months to use, but this system allows you to use your fistula within weeks.
There are many advantages to getting an AV fistula. This includes:
Because it’s created using your own blood vessels, there’s no foreign material that could lead to infections. The absence of synthetic material reduces the chances of clot formation.
AV fistulas tend to last longer than AV grafts with fewer complications.
The natural connection allows for better circulation, which enhances dialysis efficiency. This means that your sessions, especially if using the Ellipsis system, are quicker.
While an AV fistula has many advantages, it might not be right for you if you have small or weak veins. An AV graft is a synthetic tube that connects an artery to a vein and provides a pathway for dialysis access.
Unlike a fistula, an AV graft doesn’t require the natural enlargement of veins and can be used sooner after placement. Because AV grafts use synthetic material, they’re more prone to infections and clots compared to AV fistulas. AV grafts generally don’t last as long as fistulas and may require replacement or additional procedures over time.
AV grafts have some advantages, too. They:
AV grafts can be used within 2-4 weeks after placement, compared to the longer maturation time (3-6 months) of a non-Ellipsis system AV fistula.
This is good news for people who aren’t candidates for an AV fistula. You may still be able to receive an AV graft.
The choice between an AV fistula and an AV graft depends on several factors, including your vein condition, overall health, and how soon dialysis access is needed. In general, AV fistulas are preferred due to their lower risk of infection and longer lifespan, but AV grafts can be a good alternative if you don’t have suitable veins for a fistula.
Your Vascular Specialists provider can recommend the right type of access for you. Our team also monitors your access for signs of blood clots so the health and function of your access site doesn’t become compromised.
To learn more about dialysis access, call us at 815-824-4406 or schedule a consultation with our team in Tinley Park, Illinois, and Munster, Indiana.
