Page 72 - Virtual Vascular Vol 8
P. 72

AV Graft for Dialysis





                                                                                                                                                                                          •    For creation of a forearm loop

                                                                                                                                                                                               AVG



                                                                                                                                                                                                  •    Subcutaneous tunnels are

                                                                                                                                                                                                       created by curved metal

                                                                                                                                                                                                       tunnellers
                                                                                                                                                                                                  •    PTFE graft is passed into

                                                                                                                                                                                                       the lumen of the

                                                                                                                                                                                                       tunnellers
                                                                                                                                                                                                  •    Once the metal tunnellers

                                                                                                                                                                                                       are removed, the graft is

                                                                                                                                                                                                       placed at the
                                                                                                                                                                                                       subcutaneous level for

                                                                                                                                                                                                       future HD punctures





















       This is a patient undergoing brachio-cephalic AVG creation for long term haemodialysis.
       Incision is made over the antecubital fossa.



       Brachial artery (slung in red) and cephalic vein (slung in blue) are identified





                   AV graft (AVG) creation is considered when:



                   1. No good quality superficial veins identified on USG

                         (e.g. small, deep and tortuous veins)



                   2. A quick access is required (AVF needs time to mature)
        72                                                                                                                                                                                                                            73
   67   68   69   70   71   72   73   74   75   76   77