AV Fistula for Dialysis
An AV fistula is a surgically created connection between an artery and a vein — the best long-term vascular access for haemodialysis patients with kidney failure.
Overview
Haemodialysis requires reliable, high-flow vascular access to filter the blood effectively. An arteriovenous (AV) fistula is created by surgically connecting an artery directly to a vein (usually in the forearm or upper arm). Over 6-12 weeks, the vein enlarges and thickens (matures) to withstand repeated needle punctures.
AV fistula is the gold standard — it lasts longer, has fewer infections, and lower complication rates than AV grafts or catheters. Our vascular surgeons use meticulous microsurgical technique to create functional fistulas, including complex redo procedures and superficialisation when needed.
Causes
- End-stage renal disease requiring haemodialysis
- Chronic kidney disease stage 4-5
- Failed previous access (catheter or graft)
Symptoms
- The AV fistula itself is a surgical creation, not a pathological condition. Patients may feel a 'thrill' (vibration) over the fistula — this is normal and indicates good flow.
Diagnosis
- Pre-operative vein mapping ultrasound — assesses vein size and quality to choose the best site
- Allen test — confirms adequate collateral blood supply to the hand
- Post-operative Doppler — confirms fistula patency and flow volume
Treatment Options
Radiocephalic AV fistula
Connection at the wrist between the radial artery and cephalic vein. Preferred first choice.
Brachiocephalic AV fistula
Upper arm connection. Used when wrist veins are inadequate.
Fistuloplasty
Balloon dilatation of a narrowed fistula to restore adequate flow.
Superficialisation
Surgically repositioning a deep fistula closer to the skin for easier needling.
Frequently Asked Questions
How long does an AV fistula last?
A well-functioning AV fistula can last 5-10+ years with proper care. Regular monitoring and timely fistuloplasty for narrowings extend its life.
When can I use my AV fistula for dialysis?
It typically takes 6-12 weeks to 'mature' (enlarge and strengthen) before it can be used for needle cannulation.
Ready to Discuss Your Treatment?
Our av fistula for dialysis specialists in Kondapur are here to help. Most consultations available within 24 hours.