Differences Between AV Graft & Fistula: Advantages & Disadvantages (2024)

By Laminate Medical

When kidney function is compromised there is a need for dialysis treatments in order to filter the toxins from the blood. Dialysis requires access to the blood stream, gained by placing 2 needles in the vein – one drawing blood to the dialysis machine, and the other returning the filtered blood to the blood stream. Untreated veins cannot withstand repeated needle insertions and it is necessary to create safe, long term vascular access.

There are two types of vascular access designed for long term use: arteriovenous fistula (AF fistula) and arteriovenous graft (AV graft). A venous catheters is another form of vascular access, recommended for short term use because of high risk of infection.

The differences between AV fistula and AV graft

An AV fistula is created by directly connecting an artery to a vein, usually in the wrist, forearm or upper arm. The AV fistula causes extra pressure by increasing the blood flow into the vein, making it grow larger and stronger and providing easy access to the blood vessels.
The AV graft consists of synthetic tube implanted under the skin, connecting between the artery and the vein, and providing needle placement access for dialysis.

Advantages and disadvantages of AV fistula

The AV fistula is considered to be the best choice for vascular access.
– An AV fistula uses your own arteries and veins without the need for artificial material.
– AV fistulas provide good blood flow for dialysis, increasing the effectiveness and reducing treatment time.
– The risk of clotting or infection is significantly lower than with other forms of vascular accesses.
– AV fistulas are often a solution for people who are thought to have exhausted permanent access sites.
– AV fistula surgery is usually done on an outpatient basis, under local anesthetic, allowing for a rapid and easy recovery.
– AV fistulas last years longer than other forms of vascular access and can last for decades.
– AV fistulas are less expensive to maintain then AV Grafts or Venus catheters.

– The AV fistula requires several weeks to months to mature before it can be used.
– People with acute renal failure may need temporary vascular access until fistula is strong enough for cannulation.
– AV fistulas may not be suitable for people with small or weak veins.
– The most common problem with the AV fistula is stenosis, the narrowing of the blood vessel, which may lead to a decrease in blood flow or formation of blood clots.
– Strengthening the AV fistula requires daily exercises.
– Some AV fistulas fail to mature and process must be repeated.
– AV Fistulas are visible on the forearm.

Advantages and disadvantages of AV graft

– The AV graft provides a solution for small or weak veins.
– The AV graft can be used as soon as 2-4 weeks after placement.
– AV graft surgery is usually done on an outpatient basis, under local anesthetic, allowing for a rapid and easy recovery.

– Use of synthetic material in the body.
– With AV graft there is an increased risk of blood clotting, aneurysms and infections.
– Repeated blood clots can block the flow of blood through the graft.
– AV graft tends to close more quickly than the fistula.
– AV graft needs constant attention and upkeep.
– AV graft does not last as long as a fistula and will probably need to be replaced eventually.

AV fistula is considered the most preferred vascular access method for dialysis treatment. Although AV graft offers an alternative to fistula for patients with small or weak veins, it increases the risk of blood clotting, aneurysms and infections. Read more about Laminate Medical Technologies solution for AV fistula failure.

Differences Between AV Graft & Fistula: Advantages & Disadvantages (2024)


Differences Between AV Graft & Fistula: Advantages & Disadvantages? ›

An AV fistula doesn't require any artificial material, unlike an AV graft, which requires the use of a synthetic tube. Blood flow rate. AV fistulas provide greater blood flow for more effective dialysis and reduced treatment times. Solution for problem veins.

What is the advantage of fistula over graft? ›

Because they are a natural part of the body, they last much longer and are less expensive to maintain than a graft or catheter. They also offer a much lower risk of infection or clotting, which means fewer complications for patients who are already dealing with regular dialysis.

What are the disadvantages of AV graft? ›

– With AV graft there is an increased risk of blood clotting, aneurysms and infections. – Repeated blood clots can block the flow of blood through the graft. – AV graft tends to close more quickly than the fistula. – AV graft needs constant attention and upkeep.

What is the disadvantage of a fistula? ›

Blood flows more quickly through an arteriovenous fistula than it does through typical blood vessels. The increased blood flow makes the heart pump harder. Over time, the strain on the heart can lead to heart failure.

What are the two disadvantages of having a graft? ›

Infection. Loss of grafted skin (the graft not healing, or the graft healing slowly) Reduced or lost skin sensation, or increased sensitivity.

What is the difference between AV graft and fistula? ›

AV fistula and AV graft are surgical vascular access options that you need before you begin regular hemodialysis treatments. AV fistula, used for long-term dialysis, connects a selected artery and a vein directly. An AV graft connects the artery and vein indirectly, through a tube and graft.

What is the difference between a graft and a fistula? ›

Like an AV graft, an AV fistula connects an artery to a vein to prepare for dialysis. Unlike AV grafts, the fistula does not use a prosthetic; it is the surgical connection of a vein and an artery that eliminates some complications and risks associated with a graft.

What is the biggest problem with a graft for dialysis? ›

Grafts are not used as often for dialysis access as fistula because they don't last as long and tend to have higher rates of infection.

How long can you have AV graft? ›

AV grafts can be safely used in about two weeks, as no maturation of the vessels is necessary. Grafts have a lifespan of approximately 2 to 3 years but can often last longer.

How long does AV graft take to heal? ›

Arteriovenous fistulas can take between 6-12 weeks to mature and arteriovenous grafts can generally be used 2-3 weeks after surgery.

Is a fistula or graft better for dialysis? ›

A fistula should be considered the first choice for your access because it generally lasts longer and has fewer problems such as infections and clotting. However, some patients may not be able to receive a fistula because their blood vessels are not strong enough. A graft is considered the second choice for an access.

Why is fistula preferred? ›

A mature, usable AV fistula is generally preferred to an AV graft for incident AV hemodialysis access due to fewer long-term vascular access events (eg, thrombosis, loss of primary patency, interventions) associated with unassisted AV fistula use [1].

Are AV fistulas bad? ›

Regardless of the cause, serious complications can develop if a large AV fistula is not treated, including heart failure, blood clots, leg pain, and stroke or bleeding.

What are the alternatives to AV fistula? ›

A graft is a great alternative if your veins are too small or weak for a fistula. It offers better blood flow and has a lower risk of infection than an HD catheter. A graft may be replaceable with a fistula if veins get stronger or bigger after being on dialysis.

Which is better AVF or AVG? ›

An AVF is the preferred type of dialysis access given the likelihood that it will work longer with less complications. Unfortunately, an AVF cannot be created in all patients' secondary to small or diseased veins. A decision to place either an AVF or AVG is made at the time of consultation with a vascular surgeon.

What are the advantages and disadvantages of grafting? ›

Nursery graftingField grafting
Grafting can be done under any weather condition.Grafting restricted under adverse weather conditions.
Easy to protect grafting material during grafting.Difficult to protect grafting material from desiccation during the field work.
8 more rows

What are the advantages of a fistula? ›

  • • Lower risk of infection due to autologous vein1-4. • Lower risk of thrombosis compared to AV graft due to:5. ...
  • 1Palder SB, et al. Ann Surg 1985; 202:235-9. ...
  • • Require at least 1 month to adequately develop, preferably 3–4 months1. o Difficult to predict adequate development.

What are the pros and cons of fistula surgery? ›

Risks and complications

Common complications from fistula surgery include infection, bleeding, and adverse reactions to the anesthetic. Specific complications of anal fistula surgery include: a person losing control of their bowel. taking a long time for the wound to heal.

Top Articles
Latest Posts
Article information

Author: Domingo Moore

Last Updated:

Views: 5788

Rating: 4.2 / 5 (73 voted)

Reviews: 88% of readers found this page helpful

Author information

Name: Domingo Moore

Birthday: 1997-05-20

Address: 6485 Kohler Route, Antonioton, VT 77375-0299

Phone: +3213869077934

Job: Sales Analyst

Hobby: Kayaking, Roller skating, Cabaret, Rugby, Homebrewing, Creative writing, amateur radio

Introduction: My name is Domingo Moore, I am a attractive, gorgeous, funny, jolly, spotless, nice, fantastic person who loves writing and wants to share my knowledge and understanding with you.