A professional vascular surgeon can carry out a complete vessel assessment before surgery
and, according to each patient’s vessel condition, propose the most suitable way of creating access for that patient.
Native fistula, AVF (ArterioVenous Fistula)
Using your own artery and a superficial vein as a long-term dialysis access has many advantages, including being less prone to blockage and a lower infection rate. However, it cannot be used immediately after surgery and needs a period of waiting for the vessel to mature. The purpose of maturation is for the vessel wall to thicken (arterialize) and the vessel to enlarge so that it can later be needled for dialysis. Depending on vessel quality, maturation may take from six weeks to six months, and during this time balloon-assisted maturation (BAM) may be used to speed up the process.
Graft, AVG (ArterioVenous Graft )
If a patient has no suitable superficial vein for creating dialysis access, a synthetic graft is another option. Its advantages include being usable 3 to 4 weeks after surgery, without waiting for the vessel to mature, thicken and enlarge. In recent years there are also newer grafts, early cannulation grafts, which allow needling for dialysis right away within 24 to 48 hours after surgery, greatly shortening the time patients depend on a dialysis catheter and reducing catheter placement and related complications. The chance of graft blockage and infection is relatively somewhat higher, but regular clinic follow-up and maintenance of the vessel can effectively lower the chance of blockage and infection.
