Vascular Access for Hemodialysis
For patients with chronic kidney failure, regular dialysis (often 2–3 times a week) becomes a critical part of life. To make this possible, a vascular access point is created, allowing the dialysis machine to safely draw and return blood during treatment.
Types of Vascular Access
Arteriovenous (AV) Fistula
AV Graft (Synthetic Graft)
Vein Transposition (Complex AV Access)
1. Arteriovenous (AV) Fistula
- What it is: A natural connection made between a vein and artery, usually in the wrist or elbow.
- Procedure: Performed under local anesthesia. Blood flow in the vein increases, and the vein enlarges over time.
- When ready: Takes 4–6 weeks to mature and be usable for dialysis.
- Advantages:
- Longest-lasting
- Lower risk of infection or clotting
- Most preferred access type
2. AV Graft (Synthetic Graft)
- What it is: A soft artificial tube used to connect an artery and a vein in the arm.
- When it’s used: When the patient’s veins are not suitable for an AV fistula.
- Advantages:
- Ready for use sooner than a fistula (typically in 2–3 weeks)
- Limitations:
- Higher risk of infection or blockage compared to a fistula
3. Vein Transposition (Complex AV Access)
- What it is: A more advanced surgical procedure where a deep vein (like the basilic vein) is repositioned closer to the skin’s surface.
- Why it’s done: For patients in whom standard AV fistula or graft procedures have failed or are not suitable.
- Procedure: Done under regional anesthesia by experienced vascular surgeons.
- Expertise at Aashray: Deval Parikh and team specialize in these complex dialysis access surgeries, offering hope for patients needing secondary or rescue procedures.
Summary: Which Access is Right for You?
Type | Maturity Time | Durability | Infection Risk | Complexity |
AV Fistula | 4–6 weeks | High | Low | Simple (first-line) |
AV Graft | 2–3 weeks | Moderate | Higher | Moderate |
Vein Transposition | 4–6 weeks+ | High | Low | Complex (when others fail) |
👩⚕️ At Aashray Urology Institute, we offer personalized vascular access planning and advanced surgical care for first-time and complex dialysis patients.
