Arteriovenous Graft Excision

Medically reviewed by Drugs.com. Last updated on May 4, 2025.

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• Ambulatory
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AMBULATORY CARE:

An arteriovenous graft (AVG) excision

is surgery to remove the AVG. You may need this surgery if the AVG weakens the artery or causes pain. A blood clot, heart problems, or swelling are also reasons to have the AVG removed.

How to prepare for an AVG excision:

• Your surgeon will talk to you about how to prepare. He or she may tell you not to eat or drink anything after midnight on the day of your surgery. Arrange to have someone drive you home when you are discharged.
• Tell your surgeon about all your current medicines. He or she will tell you if you need to stop any medicine for surgery, and when to stop. He or she will tell you which medicines to take or not take on the day of your surgery.
• Tell your surgeon about all your allergies, including to antibiotics or anesthesia. You may be given an antibiotic to help prevent a bacterial infection.

What will happen during an AVG excision:

• You may be given general anesthesia to keep you asleep and free from pain during surgery. You may instead be given local or regional anesthesia to numb the surgery area. With local or regional anesthesia, you may still feel pressure or pushing during surgery, but you should not feel pain.
• Your surgeon will make an incision in your arm. He or she will look for signs of infection. He or she may need to drain the infection or remove damaged tissue. Your surgeon will also check for and repair problems such as damage to the vein or artery. Part or all of the AVG will be removed.
• Your incision will be closed and covered with a bandage.

What to expect after an AVG excision:

• Your arm may feel sore for several days after your surgery. You may have mild bruising or swelling near the surgery area. The surgery area may drain a few drops of blood or pink fluid for 24 hours.
• You will need to watch for and treat signs of a bacterial infection. Healthcare providers may come to your home to help you care for the surgery area.
• A new AVG may be placed about a month after surgery, if needed. The new AVG may need to be placed in a different artery than before.
• Medicines may be given to prevent or treat pain, a bacterial infection, or blood clots.

Risks of an AVG excision:

You may bleed more than expected or get an infection. You may develop a blood clot in your arm or leg. This may become life-threatening. You may develop a hematoma (collection of blood under the skin) in the surgery area.

Call your local emergency number (911 in the US) if:

• You feel lightheaded, short of breath, and have chest pain.
• You cough up blood.
• You have trouble breathing.
• The bleeding from the surgery area does not stop, even after you hold firm pressure for 10 minutes.

Seek care immediately if:

• Your arm, hand, or fingers are cold, numb, blue, or pale.
• Your bruise suddenly gets bigger.
• You have trouble moving your arm or hand.
• Your arm or leg feels warm, tender, and painful. It may look swollen and red.

Drugs used to treat this and similar conditions

Call your surgeon or hematologist if:

• You have a fever or chills.
• Your surgery area is red, swollen, or draining pus.
• You have nausea or are vomiting.
• Your skin is itchy, swollen, or you have a rash.
• You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

• Blood thinners help prevent blood clots. Clots can cause strokes, heart attacks, and death. Many types of blood thinners are available. Your healthcare provider will give you specific instructions for the type you are given. The following are general safety guidelines to follow while you are taking a blood thinner:
  • Watch for bleeding and bruising. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
  • Tell your dentist and other healthcare providers that you take a blood thinner. Wear a bracelet or necklace that says you take this medicine.
  • Do not start or stop any other medicines or supplements unless your healthcare provider tells you to. Many medicines and supplements cannot be used with blood thinners.
  • Take your blood thinner exactly as prescribed by your healthcare provider. Do not skip a dose or take less than prescribed. Tell your provider right away if you forget to take your blood thinner, or if you take too much.
• Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly.
• Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
• Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell your provider if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Care for the surgery area as directed:

Remove your bandage in 48 hours, or as directed. You may be given specific instructions to follow for how to care for the surgery area. Healthcare providers may come to your home to care for the area. The following are general guidelines to help prevent or manage an infection:

• Wash your hands before you care for the area. It is important to wash your hands to prevent a bacterial infection. Use soap and running water. Dry your hands with a clean towel or paper towel.
• Carefully wash around the area with soap and water. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty.
• Look for signs of infection with each bandage change. Signs include red streaks, pus, and more swelling than usual. A fever can also be a sign of infection.

If you have bleeding from the surgery area,

apply firm, steady pressure with clean gauze or a towel for 5 to 10 minutes. Call your local emergency number if bleeding becomes heavy or does not stop with firm pressure.

Apply ice

on the surgery area to help with swelling and pain. Use an ice pack, or put crushed ice in a plastic bag. Cover the bag with a towel before you apply it to your skin. Apply ice for 15 to 20 minutes every hour, or as directed.

Elevate your arm

above the level of your heart as often as you can. This will help with swelling and pain. Prop your arm on pillows or blankets to keep it elevated comfortably.

Follow up with your surgeon or hematologist as directed:

You may need to return to have another AVG replaced. You may also need to go in every 3 to 6 months to have the surgery area checked. Write down your questions so you remember to ask them during your visits.

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