Arteriovenous Fistula Surgery Steps
Arteriovenous Fistula Surgery is usually done using a local anesthetic that is injected into the forearm at the site of the proposed fistula. The procedure is performed in a hospital or at an outpatient surgery if the patient is not already hospitalized and has no serious underlying disease.
After cleaning and sterilizing the site, the surgeon makes a small incision in the forearm sufficient to allow the permanent uniting of a vein and an artery. The blood vessels will be appropriately blocked to stop blood flow while incisions are made to join them. Silk sutures, just as those used in other types of surgical incisions, are used to close incised areas as needed after the vein and artery have been joined. Once joined, blood flow increases. The vein will become thicker, and over a period of months the connection will become strong and develop into the fistula that will allow permanent vascular access.
After Arteriovenous Fistula Surgery Care
The hemodialysis patient should expect needle insertion in the AV fistula at every dialysis session. Patients who prefer to insert their own needles or who perform dialysis at home will need training, and all patients have to learn how to avoid infection and to protect the vascular access. Because vascular access problems can lead to treatment failure, the AV fistula requires regular care to make dialysis easier and to help avoid clots, infection, and other complications.
Patients can help protect the access by:
- Making sure the access is checked before each treatment;
- Not allowing blood pressure to be taken on the access arm;
- Checking the pulse in the access every day;
- Keeping the access clean at all times;
- Using the access site only for dialysis;
- Taking care not to bump or cut the access;
- Avoiding wearing tight jewelry or clothing near or over the access site;
- Avoiding lifting heavy objects or putting pressure on the access arm; and
- Sleeping with the access arm free, not under the head or body.