Spiral Flow™ AV Access Graft – Cannulation Guidelines
Your patient has a Spiral FlowTM AV Access Graft for their lifeline. The Spiral Flow™ AV Access Graft has some special features that are unique from all other ePTFE dialysis grafts that are important for you to know about.
Special Features of the Spiral Flow™ Graft
On the venous end of the graft is an injection moulded helical ridge that remodels the blood flow inside the graft into the normal pattern of blood flow. It is called a SPIRAL FLOW™ INDUCER. You will not be able to feel it.
What you will be able to feel is the Inducer indicator Ring.
This ring is molded onto the outside of the graft near the venous end, just over the leading edge of the SPIRAL FLOW™ INDUCER.
It can be palpated (felt) through the skin.
DO NOT CANNULATE between the INDUCER INDICATOR RING and the graft/vein anastomosis.
This no cannulation area is usually longer than what is seen on ordinary grafts. By avoiding cannulation in this area, you will help to extend the useful life of the graft.
Spiral Flow™ Grafts produce little or no turbulence across the venous anastomosis. The thrill may be less intense than standard grafts, and the bruit may be difficult to detect. Use ultrasound to determine graft patency.
Cannulating the Spiral Flow™ Graft
Like other grafts, the Spiral Flow™ Graft should be cannulated using established clean technique. The needle should be held at a 35° to 45° angle to the graft, adjusted for graft depth. Upon entering the graft, you should level off and insert the needle up to its hub if there are no obstructions or resistance. Flipping of the needles is not recommended.
De-cannulating the Spiral Flow™ Graft
When withdrawing the dialysis needle, make sure the needle is completely out of the graft before you compress the site. Use the two-finger technique recommended by K/DOQI for needle site compression.
Other Points for Consideration
- Rotate the cannulation sites
- Do not repeatedly cannulate the same area. Repeated cannulation may lead to formation of a haematoma or a pseudoaneurysm. Do NOT cannulate within the dialysis needle’s length of the proximal anastomosis or beyond the inducer indicator ring towards the distal anastomosis
- Strictly adhere to aseptic technique to minimise infection
- Apply moderate digital pressure to the cannulation site after needle withdrawal. This compression assists in haemostasis
- Instruct the patient as to proper post-operative care