Reliable long-term vascular access is essential for patients with end-stage renal disease requiring hemodialysis. The preferred form of permanent access is an arteriovenous fistula (AVF), created by surgically joining an artery and a vein, most commonly at the wrist or elbow. When a suitable native fistula cannot be formed, an arteriovenous graft (AVG) using prosthetic material may be used as an alternative. Both options allow repeated needle access for dialysis with lower infection and complication rates than tunnelled central venous catheters.
Dr Garbowski and the team at Perth Vascular Clinic are experienced in the full range of vascular access procedures, including primary fistula formation, graft placement, and salvage procedures for failing or thrombosed access. Early referral prior to dialysis commencement allows time for the fistula to mature, maximising the chance of successful long-term access and avoiding the need for temporary catheters.
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Frequently Asked Questions
Patients requiring haemodialysis need a vascular access point that can provide the high blood flow rates needed for effective dialysis. The preferred access is an arteriovenous (AV) fistula, created surgically by connecting an artery and vein. AV grafts and tunnelled dialysis catheters are alternatives when an AV fistula is not possible.