AV FISTULA Surgery And Alternate Access Options For Dialysis Patients

An AV Fistula  is the term used for a surgically created connection between an artery and a vein, usually on the arm or forearm.

A Vascular Surgeon is the specialist for creating an AV Fistula, which serves as a lifeline for patients with end-stage disease of the kidneys requiring dialysis.

     A surgically created AV Fistula for dialysis

There are many options of the combination of artery and vein to be used for AV fistula on both arms. A good ultrasound doppler of the arm veins helps us to decide which is the best site for an AV Fistula surgery.

After an AV fistula is surgically created,  it needs a maturation time of about 4 - 6 weeks, after which it may be used for dialysis access.

  A fully matured AV Fistula, ready for dialysis access

The biggest advantage of an AV fistula is that it is a permanent solution for Dialysis throughout the lifetime of a patient, and carries minimal chances of failure and infection as it does not involve any artificial tube or graft to be placed inside the body.

If an AV fistula surgery is not possible due to unsuitable veins on the arms, a synthetic tube graft known as an AV graft may be surgically placed on the arm.

A surgically placed AV Graft for dialysis access

If an AV Fistula is failing, does not mature or gets blocked, there are many options for salvage of the fistula both surgically (thrombus removal) and endovascularly (Balloon angioplasty), to make it functional again.

A temporary venous access using different types of catheters may also be attained for dialysis, and involves placement of simple (Temporary) as well as complex (Permanent) catheters such as the PERMACATH for dialysis patients.