Arteriovenous Fistula (AV Fistula)

Arteriovenous Fistula (AV Fistula) is made by joining an artery and a vein under the skin in your arm. When the artery and vein are joined, the pressure inside the vein increases, making the walls of the vein stronger. The stronger vein can then receive the needles used for hemodialysis.

To receive hemodialysis you need a blood access that can be used repeatedly with good blood flow. Your surgeon creates this blood access by making you a fistula. A fistula is created by uniting one of your arteries with one of your veins. If your vessels are suitable, the surgeon can directly connect your artery to your vein. In patients who are older or whose vessels are too small, the surgeon may choose to use an artificial blood vessel graft to connect your artery and vein.
  • Bleeding
  • Swelling
  • Infection
  • An arteriovenous fistula is not functioning or clotting
The success of the procedure depends on a number of factors including the patient’s condition, pre- and post-procedure care. Please discuss the likelihood of success with your doctor before 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
Central Venous Catheter in some cases if quick access is needed or when the veins in the arms are too small, a central venous catheter is used. This is a soft tube that is surgically inserted into a large vein in the neck or near the collarbone. This method is usually temporary until a permanent access site is ready.
Important information
  1. The dialysis staff will rotate puncture sites each time you use your fistula for dialysis to preserve the life of your fistula.
  2. Leave your post-dialysis dressing in place for 8 to 10 hours. If there is breakthrough bleeding, apply gentle pressure to the site with a clean gauze square till the bleeding stops, about five minutes. Then re-cover the site with a Band-Aid.
  3. The dialysis staff will be monitoring the pressure in your fistula during dialysis. And an unusual rise in the venous pressure may suggest your fistula is trying to clot. The physician may have your fistula evaluated with a fistulogram. This test takes pictures of your fistula and lets your physician know if your fistula may need repair to keep it functioning.

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