7 Common Mistakes with AV Fistula Needles to Avoid
Arteriovenous (AV) fistulas are widely considered the gold standard for vascular access in hemodialysis. However, even a well-developed fistula can fail prematurely if an
AV fistula needle is used incorrectly. From improper needle selection to poor insertion technique, small mistakes can lead to serious complications, reduced dialysis
efficiency, and higher medical costs.
This article highlights seven common mistakes with AV fistula needles and explains how to avoid them using best clinical and procurement practices.
Why Proper AV Fistula Needle Use Matters
An AV fistula is a long-term vascular access that requires careful management. The correct AV fistula needle size, accurate AV fistula needle insertion, and reliable medical supplies all play a critical role in:
Maintaining adequate blood flow
Minimizing vessel trauma
Reducing infection and infiltration risks
Extending fistula lifespan
Before exploring each mistake in detail, the table below provides a quick overview.
Common AV Fistula Needle Mistakes at a Glance
| Common Mistake | Potential Risks | Recommended Solution |
| Wrong AV fistula needle size | Vessel damage, poor blood flow | Match gauge to fistula maturity and prescribed flow |
| Incorrect insertion angle | Infiltration, hematoma | Maintain 20°–35° insertion angle |
| Wrong bevel orientation | Turbulent flow, pain | Follow standard bevel-up guidelines |
| Reusing disposable needles | Infection, needle dullness | Use sterile, single-use medical supplies |
| Poor needle fixation | Needle dislodgement, bleeding | Secure with proper fixation techniques |
| Ignoring patient differences | Repeated access failure | Adjust technique per patient condition |
| Low-quality medical devices | Increased complications | Choose certified medical device suppliers |
1. Choosing the Wrong AV Fistula Needle Size
Selecting an inappropriate AV fistula needle size is one of the most common clinical errors. Larger gauges (14G–15G) allow higher blood flow but may traumatize
immature fistulas. Smaller gauges (16G–17G) are safer for new access but may limit dialysis efficiency.
Best practice:
Always select needle size based on fistula maturity, vessel diameter, and prescribed blood flow rate.
2. Incorrect AV Fistula Needle Insertion Angle
Improper AV fistula needle insertion can quickly compromise vascular access. A steep angle may puncture through the vessel, while a shallow angle increases infiltration
risk.
Best practice:
Insert the needle at a controlled angle (typically 20°–35°) and reduce the angle once blood flashback appears.
3. Incorrect Bevel Orientation
Bevel direction directly affects blood flow dynamics. Incorrect orientation can cause vessel wall trauma, increased pain, and unstable blood flow during dialysis.
Best practice:
Follow facility protocols and manufacturer instructions regarding bevel-up or bevel-down insertion.
4. Reusing Disposable AV Fistula Needles
AV fistula needles are designed as single-use medical devices. Reuse significantly increases infection risk and compromises needle sharpness, leading to painful insertions.
Best practice:
Use only sterile, single-use AV fistula needles supplied by trusted medical supply manufacturers.
5. Poor Fixation After Needle Insertion
Even with correct insertion, inadequate fixation can cause needle movement during dialysis, resulting in infiltration or accidental dislodgement.
Best practice:
Secure the AV fistula needle using medical tape or stabilization devices without restricting blood flow.
6. Ignoring Patient-Specific Factors
Not all AV fistulas are the same. Repeatedly cannulating the same site or ignoring vessel depth and skin condition increases complication rates.
Best practice:
Rotate cannulation sites and customize AV fistula needle size and insertion technique for each patient.
7. Using Low-Quality Medical Supplies
Low-quality AV fistula needles may have inconsistent sharpness, inferior coatings, or weak hubs. While cheaper, they often lead to higher long-term costs due to
complications.
Best practice:
Source AV fistula needles from certified medical device and medical supply manufacturers that meet ISO and CE standards.
Conclusion
Avoiding these seven common mistakes can significantly improve dialysis outcomes and prolong AV fistula lifespan. Correct AV fistula needle selection, standardized AV
fistula needle insertion, and high-quality medical supplies are essential for safe and effective hemodialysis.
For dialysis centers, hospitals, and global medical supply buyers, investing in reliable AV fistula needles is both a clinical and economic advantage.