Arteriovenous Fistulas
August 24th, 2017
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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