What is an Arteriovenous fistula?

An Arteriovenous fistula is a form of surgery that connects an artery directly to a vein for dialysis. A procedure applied in removing the waste and toxins in the body due to faulty functioning kidneys. The dialysis machine uses the AV Fistula as an access point. With time, dialysis fistula surgery is a viable means of managing chronic renal illnesses. The most common site for an AV fistula to occur is the hand. The AV fistula surgery is done by a vascular surgeon, usually as an outpatient. You may go home the same day that you have the surgery after receiving general anesthesia.

How is AV fistula surgery carried out?

An arteriovenous fistula is an artificial connection formed for dialysis. AV fistula surgery is the process of creating this fistula. The AV fistula forms the access point for the dialysis machine. Generally, an AV fistula for dialysis is located in the arm, near the wrist or elbow. As soon as an AV fistula develops, blood flows from the artery into the vein. That increases blood volume flowing in the vein, which will consequently increase blood pressure.

Among the locations for dialysis access, most surgeons prefer the AV fistula. This is because the incidence of dialysis problems in the fistula is relatively lower with AVF dialysis. The AV fistula provides better outcomes, a longer life span, and a lesser chance of infection and clotting.

An AV graft may sometimes be placed in the arm for dialysis. An artificial tube called an AV graft surgically connects the vein and artery, whereas an AV fistula simply surgically joins the vein and artery without using an artificial tube. The tube helps blood in the vein become diverted into the artery. The process of an AV graft and an AV fistula for dialysis are identical.

What are the types of AV fistula surgery for dialysis?

Depending on the specific entangled arteries and veins, AV Fistula surgery for dialysis can be classified into three different types.

• Radiocephalic Fistula- This is one of the forearm fistulas. The connection is established between the radial artery of the arm and the cephalic vein.
• Brachiocephalic Fistula- This fistula is in the arm connecting the brachial artery with the cephalic vein. The fistula is at or above elbow level.
• BTB Fistula (Brachial artery-To-Transposed cephalic vein)- BTB fistula is created when a radiocephalic fistula or brachiocephalic fistula can't be built.

When is surgery recommended for an AV fistula?

AV fistula surgery should be included in a long-term care plan for end-stage renal failure. End-stage renal disease is a condition defined as the inability of the kidneys to remove waste materials and toxins from blood, leading to renal failure. This can be shown in the following examples:

• Large size of kidney cysts is a genetic complication that presents with polycystic kidney disease.
• Narrowing of the renal artery leading to poor blood supply to the tissues of the kidneys is called stenosis of the renal artery
• Kidney damage
• Abuse of some drugs that cause irreversible effects on the kidneys
• Kidney cancers
• Bladder and kidney infections that recur

What should I do before AV fistula surgery?

The pre-operative advice prepares the patient for AV fistula surgery for dialysis. The procedure is always carried out on an outpatient basis under general or local anesthesia.

• Once a surgeon has correctly explained the surgery, its necessity, and the advantages of having an AV fistula, a patient will be asked to sign an informed consent form.
• Discuss any of your medical history with your surgeon. This may include any drug allergies, current prescriptions, nutritional supplements, herbs, and even vitamins.
• It is recommended that the administration of blood thinners should be discontinued one week before the surgery for AV fistula to avoid excessive bleeding during and after the surgical procedure.
• A vascular surgeon examines an arm for AV fistula surgery. Generally, the non-dominant arm should be examined. Tests taken are vessel mapping, angiography, and complete blood count to assess the size, quality, and depth of arteries and veins.
• On the day of the surgery, you will be required to hold off on meals for at least four hours before the treatment.
• You would therefore need to make arrangements with a friend or family member to take you home after the AV fistula operation.

How is AV fistula surgery performed?

A procedure to establish an AV fistula for dialysis usually lasts from one to two hours.

• The surgical procedure for establishing an arteriovenous fistula for dialysis includes local anesthesia. This allows the surgeon to put his patient to sleep and anesthetize him to a certain extent.
• The surgeon makes a small incision to reach the selected arteries and veins.
• In case of an AV fistula, an incision is done to join the vein and artery. Blood can then freely move through this AV fistula from the artery to the vein.
• The surgeon makes the union of the veins and the arteries using a synthetic tube in the case of an AV Graft.
• AV fistula takes about 6 to 8 weeks to mature after it is formed. Within this period, the vein will have adequately grown to allow for easier dialysis.

What are the Advantages and Disadvantages of AV Fistula Surgery?

Advantages of AV Fistula Surgery

AV fistulas have a longer lifespan compared to any other technique before their functionality is lost.

• As the AV fistula naturally accommodates the needed blood flow, the treatment period is significantly reduced.
• There is a very small chance of infections occurring
• Unlike other types of dialysis, there is less tendency for blood clotting
• No artificial material needs to be implanted inside your body to get AV fistula surgery
• It does not require a day-long hospital stay since it is an outpatient procedure
• You could return to your daily activities pretty quickly

Disadvantages of AV Fistula Surgery

• Steal Syndrome: Not enough blood flows down to the micro-vascular arteries and capillaries, causing numbness and coolness in the fingertips. The AV shunt steals all of the blood away from going into the capillaries since there is a smaller amount of blood available.
• Allergic reaction of medication
• Excessive blood loss
• Wound site infection
• Thrombosis of the Leg vein, or the formation of blood clots in a leg vein.
• Artery or Vein Compression
• No development of AV fistula

Why Tender Palm Super-Speciality Hospital for Arteriovenous fistula surgery?

Tender Palm Hospital, owned by doctors, is renowned for attracting the most skilled professionals in the country. With the finest vascular surgeons specialized in arteriovenous fistula surgery. Tender Palm stands out as the one of the best hospital for vascular surgeries in Lucknow, India. Boasting cutting-edge infrastructure and advanced technology, Tender Palm ensures top-notch medical care for its patients.

To seek an expert consultation for any vascular condition

Call us at +91-9076972161
Email at care@tenderpalm.com

Request a Call Back