Arteriovenous Fistula (AVF)

A vascular access surgery

Patients with end stage kidney disease need either peritoneal or haemo (blood) dialysis to remove waste products & water from their blood.

Most patients are prepared for haemodialysis. In haemodialysis, blood is drawn from the patient & passed through a machine which removes the waste products & water. The "purified" blood is then returned to the patient.

To facilitate this process, an Arteriovenous Fistula (AVF) is done. An AV fistula is a communication between an artery and a vein that allows blood to flow from the artery directly into the adjacent vein.

An AV fistula may be located:

• near the wrist or forearm (called a radiocephalic fistula)
• near the elbow or upper arm (called the brachiocephalic fistula)

AVF needs time to mature & thus it is best to do this procedure 4-6 months before the start of dialysis. The success/flow rate of the operation is dependant on the size & normality of the artery & vein and a good anastomosis.

For immediate dialysis the nephrologist inserts a catherter in the vein of the neck or groin. This is done for patients who need immediate dialysis, while waiting for the AVF to mature.

Prosthetic graft is an option for patients with superficial veins not suitable for AVF.