Fundamental Technical Skills In Interventional Radiology: Closing AV Graft/Fistula Access Sites (Purse String And Toggle Technique)

OVERVIEW

After dialysis AV grafts/fistulas are accessed they can be closed using the technique shown below. This involves using a purse string suture as well as a “toggle” device (cut piece of a dilator/introducer) to securely close down the access site. The video below shows how to properly perform this technique.

HOW TO EASILY REMOVE THESE TOGGLE DEVICES

It is important to make sure that we appreciate that these “toggle” devices that are used to close down the AV graft/fistula sites should not be left in place indefinitely. Often times they should be removed 24-48 hours after their placement. The video below shows an easy way to remove these devices.

 

 

Page Updated: 03.24.2019