Why AV Fistulae?
Like most US nephrologists, Nguyen did not have any formal training in AV fistula creation and had gone with AV grafts as the default because they are simpler and quicker to create than fistulae. To create an AV fistula, a surgeon needs a well-mapped target for joining an artery and a vein, and it typically takes weeks or months for the fistula to mature before use. “Who wants to spend six months waiting?” says Nguyen. Studies show, however, that AV fistulae achieve a higher survival rate than AV grafts, with less thrombosis and infection. Nguyen also knew that most European dialysis patients receive fistulae. Making the transition became a “true passion” for Nguyen, as he describes it. Dr. Griffith helped him understand the vascular surgeon’s information needs and operating procedures. Nguyen also read extensively about AV access and talked with European nephrologists during several visits there and online with Renaliste, an email distribution list for Francophone nephrologists. Key n
