AV Fistula Flashcards
What is an Arteriovenous (AV) Fistula Creation?
Surgical procedure to create a connection between a native artery and vein in an extremity to allow for dialysis access
Why is Local Anesthesia sometimes used during AV Fistulas?
Local anesthesia used if kidneys are too damaged
What are the types of AV Fistulas?
- Cimino
- Kaufman
- Basilic
What is Patient Positioning for an AV Fistula creation?
- Supine
- Operative arm on hand table
- OR bed turned 90 degrees
Describe: Cimino Fistula.
Cephalic Vein to Radial Artery at the Wrist
Describe: Kaufman Fistula.
Cephalic Vein to Brachial Artery below the Antecubital Fossa
Describe: Basilic Fistula.
Basilic Vein to Brachial Artery above the Antecubital Fossa
What are the key instruments used during an AV Fistula creation?
- Bulldog clamps
- Vessel tunneler
Which AV Fistula creation technique is the most common?
Kaufman Technique
What is the Distal end of the Cephalic Vein ligated with during an AV Fistula creation?
Hemoclip or Silk tie
What is used to control the Proximal end of the Cephalic Vein during an AV Fistula creation?
Bulldog clamp
What technique is used to anastomose the Cephalic Vein and Brachial Artery?
End-to-side anastomosis
Why is the graft marked on one side during an AV Fistula creation?
It allows us to see if the graft has twisted or not
What must be done prior to closing after an AV Fistula creation?
- Check hemostasis
- Check for kinks in vein/graft (leads to clot formation)
- Check distal pulses
- Give Protamine
What suture is used to close the Dermis after an AV Fistula creation?
3-0 Vicryl (SH Needle)
