Why create an AV fistula in haemodialysis? - USMLE Forums
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Old 01-27-2016
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Default Why create an AV fistula in haemodialysis?

I understand the wall of the vein is thin and weak and can easily be damaged after a couple of uses. By connecting it to an artery and after a couple of months of high blood-flow (from the artery) through this vein, it will balloon out (ie thicken) enough to resist getting poked every other day. So the AV fistula improves the patency of the vein.

However doesn't connecting an artery to a vein have consequences?

Eg What about the areas supplied by that artery, would they not undergo ischaemia?

Thanks in advance
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Old 01-28-2016
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Quote:
Originally Posted by leot View Post
I understand the wall of the vein is thin and weak and can easily be damaged after a couple of uses. By connecting it to an artery and after a couple of months of high blood-flow (from the artery) through this vein, it will balloon out (ie thicken) enough to resist getting poked every other day. So the AV fistula improves the patency of the vein.

However doesn't connecting an artery to a vein have consequences?

Eg What about the areas supplied by that artery, would they not undergo



Thanks in advance

Those areas don't undergo ischemia, collateral are enough to keep the limb functioning plus some fraction goes into the fistula, some goes down the normal pathway. Obviously, some weakness n muscle atrophy is expected. That's why patients with AV fistula a are always advised to exercise that particular limb.
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