An arteriovenous fistula is the best and safest long-term access for haemodialysis. It is created with a small operation in the arm and needs follow-up to keep it working well.
Symptoms
- Weak thrill felt over the fistula
- Difficult needling during dialysis
- Arm swelling
- Prolonged bleeding after dialysis
Causes & risk factors
- Narrowing of the draining vein or feeding artery
- Clot inside the access
- Pressure or injury to the arm
Diagnosis
Before creation, a Doppler of the arm vessels picks the best site. When an existing access fails, Doppler or angiography finds the cause and location.
Treatment options
AV fistula creation
A small operation, usually under local anaesthetic, in the arm.
Balloon angioplasty of the access
Treating narrowing endovascularly to restore function.
Clot removal
Endovascular or surgical, to rescue a blocked access.
After treatment
A new fistula needs weeks to mature before use, with simple hand exercises explained by the doctor.
Frequently asked questions
When should the fistula be created?
Ideally well before dialysis starts so it has time to mature, as advised by your nephrologist.
Can a stopped fistula be saved?
Often yes, if treated quickly after it stops.
How do I look after my fistula?
Avoid blood-pressure cuffs and blood draws on that arm, don't sleep on it, and check the thrill daily.
Content on this website is for awareness only and does not replace a specialist medical examination.