Arteriovenous fistula creation
An arteriovenous fistula is often surgically created in patients with chronic kidney diseases in order to provide peripheral vascular access for hemodialysis, i.e., removal of metabolic waste products from the blood, when kidney failure occurs.
How Is the Surgery Performed?
The surgery is usually performed under local anesthesia.
A fistula is usually created in the forearm or the upper arm, rarely in the leg, i.e., in those places where arteries and veins are large enough in diameter to form arteriovenous fistulas. During the procedure, an artery and a vein are connected so that some arterial blood would flow directly to the vein, bypassing capillaries. High-pressure arterial blood flow eventually enlarges the vein. After 2–3 weeks, the vein is widened enough to receive the needles of a dialysis machine used for hemodialysis treatments.
What Should Be Known After Surgery?
- The stitches are removed 2 weeks after the surgery, when the wound heals completely;
- Appropriate care of the fistula should be taken. No blood should be drawn from or blood pressure should be taken on the arm with the fistula created. The patient should avoid putting the access forearm under the head while sleeping or wearing tight clothing over the access forearm or upper arm.
- Light physical activities using this arm are allowed after 1 week postoperatively.