Arteriovenous Fistula (AVF)

Placing an arteriovenous fistula (AVF) requires connecting a vein to an artery. Arteries are high-flow vessels that take blood from your heart to your arm. Veins are lower-flow vessels that take blood the opposite direction, from your arm to your heart. A normal arm vein is not big enough and does not have enough flow for effective dialysis. Also, placing needles directly into the artery for dialysis, could compromise blood flow to the hand. When our surgeons connect a vein to the artery, the vein “arterializes”– it enlarges and develops thick walls like an artery, making it useable for dialysis.

Most fistulas are placed through a small incision in the arm. The surgery is performed under a local or general anesthetic as an outpatient procedure and generally takes less than an hour. Before it can be used for dialysis, an AVF requires at least two to three months to dilate and thicken enough to support the dialysis needles. For this reason, it is important to place the AVF well in advance of when you need to start dialysis in order to avoid the need for a dialysis catheter.

After surgery, do not let anyone draw blood, start an intravenous line, or take a blood pressure on your access arm. This can potentially damage your access.