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An arteriovenous graft serving as a fistula for hemodialysis access. A vascular bypass is often created to serve as an access point to the circulatory system for hemodialysis. Such a bypass is referred to as an arteriovenous fistula if it directly connects a vein to an artery without using synthetic material. [citation needed]
An arteriovenous fistula is an abnormal connection or passageway between an artery and a vein. [1] It may be congenital , surgically created for hemodialysis treatments, or acquired due to pathologic process, such as trauma or erosion of an arterial aneurysm .
Vascular access steal syndrome is a syndrome caused by ischemia (not enough blood flow) resulting from a vascular access device (such as an arteriovenous fistula or synthetic vascular graft–AV fistula) that was installed to provide access for the inflow and outflow of blood during hemodialysis.
If treatment involves embolization, it will only typically be effective if the glue traverses the actual fistula and enters, at least slightly, the draining vein. [citation needed] The Cognard et al. Classification [10] correlates venous drainage patterns with increasingly aggressive neurological clinical course.
Surgically created AV fistulas work effectively because they: Have high volume flow rates (as blood takes the path of least resistance; it prefers the (low resistance) AV fistula over traversing (high resistance) capillary beds). Use native blood vessels, which, when compared to synthetic grafts, [5] are less likely to develop stenoses and fail.
Ischemic monomelic neuropathy is a complication of arteriovenous fistula access for hemodialysis. [4] Patients with diabetes and women are more likely to experience ischemic monomelic neuropathy. [5] [6]
In an AV fistula, there is shunting of blood from the arteries directly into a vein, bypassing the capillary beds. This causes a fall in peripheral vascular resistance. Because blood pressure is directly proportional to peripheral vascular resistance, in an AV fistula there is a fall in blood pressure and subsequent reflex tachycardia.
An arteriovenous malformation (AVM) is an abnormal connection between arteries and veins, bypassing the capillary system. Usually congenital , this vascular anomaly is widely known because of its occurrence in the central nervous system (usually as a cerebral AVM ), but can appear anywhere in the body.