Today, for our patients preparing for hemodialysis treatment due to chronic kidney failure, the most vital stage of the process is the creation of a healthy and reliable vascular access. In order for the dialysis machine to clean the blood outside the body and return it, an access point that is suitable for continuous use, durable, and capable of providing high blood flow is needed. This access point is the most fundamental element that ensures the patient undergoes dialysis sessions comfortably and efficiently.
For many of our patients, the first choice is the AV Fistula procedure, which is created by connecting their own natural blood vessels. However, human anatomy is unique, and every patient’s vascular structure may not be suitable for this natural connection. In cases where the vessels are structurally too thin, worn out due to past treatments, or previous vascular accesses have lost their function, a very strong and reliable alternative offered by medicine comes into play: AV Graft Application.
In this comprehensive guide, we cover in full detail, from an expert perspective, what the AV Graft (Artificial Blood Vessel) application—which serves as a perfect “bridge of life” for our dialysis patients—is, in which situations it is preferred, how the surgical process proceeds, and the unique advantages it provides.
What is an AV Graft, What Does it Do?
An AV Graft (Arteriovenous Graft) is a specially manufactured, biocompatible synthetic tube placed under the skin between the patient’s own artery and vein. Acting just like a natural blood vessel, this flexible and durable tube creates an artificial tunnel, a bridge for the high-pressure clean blood to pass from the artery to the vein.
During dialysis treatment, it is essential that blood is delivered to the machine in sufficient quantity and speed. In cases where the natural vascular structure is too weak to provide this flow, these artificial vessels (grafts), which are marvels of medical technology, are used. Designed to be in perfect harmony with the human body, these tubes are wide and durable enough for dialysis nurses to easily insert needles. Placed under the skin in a U-shape or straight form, the AV Graft comfortably meets the high blood flow rate required by the machine, ensuring that your dialysis session is spent with maximum efficiency.
In Which Situations is an AV Graft Preferred?
The dialysis process is a meticulous journey that needs to be planned specifically for the patient. As a Cardiovascular Surgeon, when planning the vascular access, we map the anatomical structure of your arms with Color Doppler Ultrasound. The AV Graft application stands out as the most ideal and safe option in the following situations:
- Thin Vascular Structure: If the patient’s own veins are genetically too thin and weak to handle and expand under the high-pressure blood flow.
- Worn-Out Vessels: In patients who have received IV therapy for a long time in the past, have had frequent blood draws, or whose superficial veins in the arm have been damaged due to different treatments.
- Previous Failures: If previously created natural AV fistulas have lost their function for various reasons and there are no suitable natural vessels left in the patient’s arm to create a fistula.
- Need for Rapid Use: While the maturation (becoming ready for use) of natural fistulas takes weeks, if the patient needs to start dialysis in a shorter time via a permanent access.
How is an AV Graft Applied? The Surgical Process
The AV Graft application is a special microsurgical procedure that is highly comfortable for the patient and requires fine craftsmanship. Prioritizing the patient’s comfort, the process proceeds with the following steps:
- Vascular Mapping (Ultrasound): Before the procedure, the arteries and veins in the arm are examined with millimeter precision using ultrasound. The most accurate and safe route where the artificial vessel (graft) will be placed is determined.
- Comfortable Anesthesia: The procedure is generally performed with local or regional anesthesia, where only a specific part of the arm is numbed, without the need for general anesthesia. You will remain awake throughout the procedure and will not feel any pain or ache.
- Surgical Placement: Once numbness is achieved, a thin tunnel is created under the skin by entering through very small incisions made on the skin. The biocompatible artificial vessel is placed inside this tunnel. One end of the graft is carefully sutured to the artery and the other end to the vein using microsurgical threads, initiating blood flow.
- Discharge: The operation is generally completed between 1 and 1.5 hours. Our patients can walk back to their homes on the same day after the procedure and adapt to their daily routines in a short time.
Advantages the AV Graft Provides to the Patient
As one of the most valuable options modern medicine offers to dialysis patients, the AV Graft has many superior features that facilitate daily life and the treatment process:
- Rapid Maturation Time: While it takes long weeks to wait for fistulas created with natural vessels to develop, AV grafts made from special materials generally become ready for dialysis needle insertion within 2 to 3 weeks (even earlier depending on the type of graft used).
- Large Surface Area: Grafts offer a highly comfortable and large needle insertion area for dialysis nurses. This eliminates the stress of finding a vascular access before every session.
- High Efficiency: Since it provides a continuous and high-volume blood flow to the dialysis machine, the quality of blood cleaning is extremely high. Our patients feel much more vigorous after the session.
- Biocompatible Structure: Because the medical tubes used are designed with features closest to human tissue, they are easily accepted by the body and take their place in the arm like a natural tissue.
Frequently Asked Questions (FAQ)
We transparently answer the questions our patients are most curious about regarding the procedure during polyclinic interviews:
1. Is the artificial vessel (graft) noticeable from the outside? The graft is a closed system placed completely under the skin. From the outside, a plastic tube is not visible on your arm; only a slight bulge can be noticed under the skin along the route where the vessel passes. This is a natural indicator of a healthily functioning vascular access.
2. Can I do my daily chores with my grafted arm? Absolutely, you can. After the healing process is complete, you can return to your normal life, go for walks, and comfortably use your arms in daily activities. It is only recommended that you avoid carrying very heavy loads with that arm or taking severe blows to the arm.
3. Can I have my blood pressure measured from that arm? Just as with natural fistulas, your grafted arm is your lifeline. Blood pressure must absolutely not be measured from this arm, and procedures such as blood draws or IV placements should not be performed other than with dialysis needles. All your routine medical procedures should always be performed on your other (healthy) arm.
Reliable Vascular Access Surgery in Kartal with Op. Dr. Nebiye Tüfekci
Creating dialysis vascular accesses is not an ordinary procedure; it is a surgical art that directly affects the patient’s long-term quality of life, freedom of movement, and treatment motivation. This sensitive process must be carried out by experienced hands that have high-level mastery over vascular anatomy and show maximum respect for human tissue.
Standing out with the trust-oriented bond she has established with her patients throughout her professional career and her deep vision in the field of microsurgery, Cardiovascular Surgery Specialist Op. Dr. Nebiye Tüfekci offers personalized, “tailor-made” solutions best suited to each patient’s structure in AV Graft applications. Our main goal is to alleviate the concerns of our patients preparing for the dialysis process and build a safe bridge that will restore their comfort of life.
We carry out the diagnosis, detailed vascular mapping, and examination processes of our valued patients in our clinic located within Bumerang Kartal Residence, with a sterile, modern approach that prioritizes patient psychology. Located in one of the most prestigious and easily accessible points of the Istanbul Anatolian Side, our clinic offers great comfort to our guests coming from surrounding districts such as Maltepe, Pendik, Tuzla, and Ataşehir, thanks to its proximity to the E-5 highway and subway lines, especially Kartal.
To attain a strong, reliable, and highly efficient vascular access in your dialysis adventure, to get detailed information about the AV Graft application, and to make your completely personalized surgical plan, you can contact our clinic at Bumerang Kartal Residence. Wishing to walk together, safely, towards healthy, painless, and hopeful tomorrows.
