AV Fistula Creation
If you've been diagnosed with End Stage Renal Disease and you require dialysis , you will need a fistula. graft, or catheter placed for dialysis access. An AV fistula is typically the best choice as it lasts the longest.
An AV fistula is a communication made by sewing together a natural vein to an artery in the arm. This is most often done through a small incision at the wrist or the elbow. We hope that over a period of eight weeks, or so, the vein will become large enough (or mature) so that let can be cannulated with needles attached to the dialysis machine.
The natural AV fistula has the best results of any type of dialysis access. Unfortunately, many patients close to needing dialysis have very poor veins which have been damaged from IV and blood draws making the creation of a fistula difficult in certain patients. Because of this and the time needed for maturation it is important that patients get evaluated for a dialysis access early and avoid blood draws or IV's in their non-dominant arm as soon as they are found to have significant kidney problems.
How is the fistula created?
The first step in AV fistula creation is to evaluate your blood vessels (veins and arteries), to ensure they are healthy enough to support a fistula. The first step in the evaluation will be a physical examination of your arms performed by your vascular specialist. The next step will involve the use of non-invasive or minimally invasive tests such as ultrasound, and possibly an angiogram to determine the size and depth of your arteries and veins. These tests will determine whether or not your blood vessels are able to support an AV fistula. These tests are often referred to as “vein mapping.” This mapping can be performed here in our very own vascular imaging laboratory or through an outside radiology facility.
Once it has been determined that you are a candidate for an AV fistula, an appointment will be scheduled for the AV fistula creation here at our surgery center Vein Treatment Access Care.
To create an AV fistula, the vascular surgeon will administer local anesthesia to the chosen access site. Next, your physician will make a small incision, allowing access to the selected arteries and veins. A surgical connection is made between an artery and a vein. This connection causes blood to flow from the artery into the vein, this increased blood flow through the vein results in enlargement of the vein and thickening of the vein walls. After the AV fistula has been created, it will take several weeks, in some cases a month or longer, for the fistula to mature to the point where it will be able to be used for your hemodialysis treatments.
How we can help?
We can perform the AV fistula creation in our on site ambulatory surgery center and help you manage your fistula when needed while you are on dialysis. We provide prompt service same day or next day for emergencies and we work every day to deliver far more than our patients expect by bringing our full range of medical capabilities and service excellence to every patient.