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What is arteriovenous (AV) fistula surgery?

Arteriovenous (AV) Graft Surgery - 460x261

Arteriovenous (AV) fistula surgery creates a place to access the body’s circulatory system to perform dialysis. Dialysis removes wastes and extra fluid from the blood when the kidneys can no longer perform this function. This is known as kidney failure. An AV fistula allows blood to flow from your body to the dialysis machine and back into your body after filtering.

AV fistula surgery involves sewing together an artery and a vein, usually in the wrist or elbow area. This creates a larger, tougher vein that can tolerate multiple needle punctures that are needed for dialysis. You can see the thickened vein and feel a pulse in it after the AV fistula heals over several months.

AV fistula surgery is only one dialysis access option. It may not be the best option for everyone, such as people with small blood vessels. Other options include an AV graft (an artificial blood vessel) and a venous catheter, which is for short-term dialysis. AV fistula surgery is generally for people who need long-term dialysis and have healthy blood vessels. 

Consider getting a second opinion about all your dialysis access choices before having AV fistula surgery.

Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 13, 2016

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Medical References

  1. Arteriovenous fistula. Encyclopedia of Surgery.
  2. Guidelines for Vascular Access. National Kidney Foundation.
  3. Hemodialysis Access: What You Need to Know. National Kidney Foundation.
  4. Manual of Anesthesia Practice: Upper Extremity AV Fistula Placement. Anesthesiacentral.
  5. Vascular Access for Hemodialysis. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC).

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