Arterial Venous Access for Dialysis

The purpose of this surgery is to create an access portal to allow you to have hemodialysis. 

What does the operation consist of?

The procedure is usually carried out under local anesthesia with intravenous sedation. The surgeon makes a small incision in your arm and attaches a vein under the skin to your artery. This results in increased blood flow and pressure in the vein. The vein enlarges and strengthens. This process, called maturation, takes between 3 - 6 months usually, rarely up to a year. This is why the operation should ideally be done a few months before you require dialysis. 

What happens after surgery

You will have absorbable sutures. You should exercise your arm to stimulate blood flow through the fistula. Your hand may feel slightly cold and numb initially but this should improve. You will have a follow-up ultrasound in the clinic one week and two months after your operation.

Complications 

Rarely the fistula does not mature in about 10% of patients and another procedure may be required. Rarely blood flow to the hand is severely reduced after fistula creation and the fistula needs to be tied off. Late complications related to fistulas can include clotting, bleeding and excessive enlargement or aneurysm formation.