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Arteriovenous Fistulas

 
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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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