What is an Arteriovenous Fistula?

An Arteriovenous (AV) fistula is a connection of an artery to a vein. Arteries carry blood from the heart to the body, while veins carry blood from the body back to the heart. A Vascular surgeons performs the AV fistula, they specialize in blood vessel surgery. The surgeon usually places an AV fistula in the forearm or upper arm.

An AV fistula causes extra pressure and extra blood to flow into the vein, making it grow large and strong. The larger vein provides easy, reliable access to blood vessels. Without this kind of access, regular hemodialysis sessions would not be possible. Untreated veins cannot withstand repeated needle insertions. They would collapse the way a straw collapses under strong suction.

Before the operation

Before AV fistula surgery, the surgeon may perform a vessel mapping test. Vessel mapping uses Doppler ultrasound to evaluate blood vessels that the surgeon may use to make the AV fistula. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A specially trained technician performs the procedure in the outpatient department. A radiologist—a doctor who specializes in medical imaging— interprets the images. The patient does not need anesthesia. A Doppler ultrasound shows how much and how quickly blood flows through arteries and veins so the surgeon can select the best blood vessels to use.