Which of the following is a potential treatment option for an AV fistula aside from compression or surgical repair?

• A. Implantation of a covered stent
• B. Anticoagulation therapy
• C. Observation only
• D. Thrombin injection

Answer: (A)

When AV fistula problems arise that aren’t resolved by simple compression or open repair, endovascular approaches offer a way to salvage and preserve the access. Implanting a covered stent graft across a diseased or vulnerable segment can exclude an aneurysm or leak and treat stenosis, while keeping the fistula patent for ongoing dialysis. This minimally invasive option maintains flow through the fistula, avoiding a loss of access and often reducing the need for more extensive surgery. Anticoagulation doesn’t address the structural issue, observation won’t fix the problem, and thrombin injection is typically used for closing a pseudoaneurysm rather than broadly repairing the fistula, making the covered stent the most appropriate choice here.