Patients that are on, or plan to start, hemodialysis have better short- and long-term outcomes if they receive dialysis through a arteriovenous fistula. The word "fistula" means an abnormal or surgically created connection between two vessels. The creation of an arteriovenous fistula, in which an artery and vein are surgically connected to each other, takes place in an outpatient surgical setting. No foreign material is inserted into the patient. The connection of the artery and vein is below the skin, so nothing is extruding from the patient after surgery.
This operation does not require general anesthesia but rather is performed with the aid of a peripheral nerve block and sedation. The operation typically takes one hour, and patients go home from the recovery room after surgery.
Once the operation is complete, it takes an average of 6-8 weeks for the vein to grow or mature enough to be usable for hemodialysis.
For patients that do not have veins suitable for arteriovenous fistula creation, a graft can be placed between an artery and a large, deep vein in the arm. The graft is then accessed by the hemodialysis staff for dialysis. The operation to place an arteriovenous graft is also an outpatient procedure and does not require general anesthesia.
Patients should make sure they do not eat or drink anything after midnight the day before their surgery. For patients who take medications in the mornings, they may take them as directed with a small sip of water.
After Your Surgery: AV Fistula/AV Graft Discharge Instructions
Common Questions Regarding Arteriovenous Fistulas