Arteriovenous Fistula (AV Fistula) is a medical procedure that involves connecting an artery and vein under the skin in your arm. This connection increases the pressure inside the vein, which strengthens its walls. As a result, the vein becomes strong enough to receive the needles used in hemodialysis.

Purpose/Benefits of AV Fistula

To undergo hemodialysis, it is necessary to have a blood access that can be used repeatedly with good blood flow. This is achieved through the creation of a fistula by a surgeon, which involves connecting one of your arteries with one of your veins. If your vessels are suitable, the surgeon may directly connect your artery to your vein. However, in cases where patients are older or their vessels are too small, an artificial blood vessel graft may be used instead to connect the artery and vein.

Risks, Complications, and Side Effects of the Procedure and Recovery

  • Bleeding
  • Swelling
  • Infection
  • An arteriovenous fistula is not functioning or clotting

Likelihood of Success

The success of the procedure is dependent on various factors, including the condition of the patient, as well as the care given both before and after the procedure. It is recommended to discuss the probability of success with your doctor prior to undergoing the procedure.

What if this procedure is not performed?

If you decide not to have this procedure, there may be associated risks to this decision.  Please discuss it with your doctor

Alternatives for AV Fistula

Central Venous Catheter: In certain situations, a central venous catheter may be utilized if immediate access is required or if the veins in the arms are too narrow. This involves placing a flexible tube into a larger vein near the collarbone or in the neck via surgery. Typically, this is a short-term measure until a permanent access site can be established.

Important information

  1. To preserve the life of your fistula, the dialysis staff will rotate puncture sites each time you use it for dialysis.
  2. After dialysis, keep your dressing in place for 8 to 10 hours. If there is any breakthrough bleeding, apply gentle pressure to the site with a clean gauze square for about five minutes until the bleeding stops. Then re-cover the site with a Band-Aid.
  3. During dialysis, the dialysis staff will monitor the pressure in your fistula. If there is an unusual rise in venous pressure, it may suggest that your fistula is trying to clot. In such a case, the physician may evaluate your fistula with a fistulogram, which takes pictures of your fistula and informs your physician if your fistula requires repair to maintain its functioning.