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Assessment of the Mature AVF

Learn how to assess mature forearm fistulas monthly for the upper arm AVF candidates using the "Sleeves Up" exam. Identify potential outflow veins early to enhance patient outcomes. Detailed protocol available at FistulaFirst.org. Notify nephrologists and surgeons for optimal utilization of upper arm veins in case of AVF or AVG failure. Ensure efficient access creation for dialysis patients.

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Assessment of the Mature AVF

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  1. Assessment of the Mature AVF

  2. “Sleeves Up” Exam • Assessment of mature forearm fistulas (as well as forearm grafts) should include a monthly “sleeves up” exam of the upper arm, to identify mature outflow veins of the forearm AVF or AVG that might be potential candidates for a future upper-arm AVF (see “Sleeves Up” protocol in Change Concept #6 at FistulaFirst.org) • If an upper-arm vein appears to be suitable for a future AVF, make note in chart and notify nephrologist and surgeon that the upper-arm vein is available as a new AVF should the existing AVF or AVG fail. Spergel LS. Protocol. National Vascular Access Improvement Initiative Web site. Available at: www.fistulafirst.org. Accessed June 26, 2006.

  3. “Sleeves Up” Exam… Outflow vein (cephalic v.) of failing forearm AV graft is suitable for conversion to AVF Photo courtesy of L. Spergel, MD

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