Arteriovenous Graft (AVG)

When there is no usable vein for an AVF, our surgeons perform an arteriovenous graft (AVG). This procedure involves tunneling a hollow, tube-shaped graft underneath the skin through a small incision in the arm or, if the arms are not favorable, the top of the leg. The graft, which is made of GORE-TEX or specially treated cow artery, is sewn to your artery on one end and your vein on the other. When you go to dialysis, the needles are put through the skin into the graft.

AVG surgery typically takes about an hour and is performed with a local or light general anesthetic. Because the graft is not your own tissue, it has a higher risk of clotting or infection than an AVF. However, it can be used sooner, often within two weeks of surgery. Just like for an AVF, you must protect your access arm. Do not let anyone draw blood, start an IV, or take a blood pressure on that arm.

Every AVG or AVF diverts blood that would typically go to the hand. This may cause some transient numbness or cramping in the hand during dialysis or if the blood pressure is low but is usually well tolerated. Uncommonly, the symptoms can be more severe. Persistent pain, numbness, or weakness in the hand must be reported immediately to your surgeon.