When is an AV graft preferred over a fistula for a patient?

An AV graft is preferred over a fistula when a patient lacks suitable vessels for a fistula. Fistulas, created by connecting an artery directly to a vein, require healthy veins with adequate size and condition for successful formation. In patients where the venous anatomy is not conducive to forming a fistula—due to factors such as previous vascular surgeries, trauma, or anatomical abnormalities—an AV graft serves as an alternative. It provides a reliable access for hemodialysis by utilizing a synthetic tube to connect an artery to a vein, which can be used as a site for needle insertion. This option ensures that patients who cannot have a fistula still have access to ongoing dialysis treatment, which is critical for their survival and quality of life.