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Arteriovenous Fistulas

Overview

  • An anastomosis between an artery and vein in the arm, created in order to dilate the vein for use in haemodialysis.
    • Look For

    • Location of fistula - radiocephalic (forearm) / brachiocephalic (AC fossa), upper arm transposed basilic fistula
    • Skin - rash, depigmentation, scars, ulceration
    • Inflammation - erythema, swelling, tenderness
    • Distal ischaemia - pain, pallor, pulselessness, paralysis, paraesthesia, poikilothermia Steal syndrome - vascular insufficiency
    • Feel For

    • Consistency - soft, easily compressible
    • Thrill - soft, continuous palpable thrill
    • Hyperpulsatility - outflow obstruction
    • Auscultate For

    • Normal bruit - soft, low-pitched hum
    • High-pitched bruit Stenosis
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