Medical knowledge, Patient Education
AV Fistula Placement
Arteriovenous (AV) fistula placement is a surgical procedure to create a connection between a blood vessel that carries blood away from the heart (artery) and a blood vessel that returns blood to the heart (vein). This connection is called a fistula. It is often made in the forearm or upper arm.
You may need this procedure if you are getting haemodialysis treatments for kidney disease. An AV fistula makes your vein larger and stronger over several months. This makes the vein a safe and easy spot to insert the needles that are used for haemodialysis.
Tell a healthcare provider about:
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Any allergies you have.
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All medicines you are taking, including vitamins, herbal medicines, eye drops, creams and over-the-counter medicines.
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Any problems you or family members have had with anaesthetics.
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Any blood disorders you have.
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Any surgeries you have had.
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Any medical conditions you have or have had in the past.
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Whether you are pregnant or may be pregnant.
What are the risks?
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Infection.
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Blood clots.
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Reduced blood flow (stenosis).
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Weakening or ballooning out of the fistula (aneurysm).
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Bleeding.
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Allergic reactions to medicines.
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Nerve damage.
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Swelling near the fistula.
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Failure of the procedure.
What happens before the procedure?
Staying hydrated
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Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, and tea and coffee without milk or cream.
Eating and drinking restrictions
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8 hours before the procedure – stop eating heavy meals or foods, such as meat, fried foods, or fatty foods.
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6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
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6 hours before the procedure – stop drinking milk or drinks that contain milk.
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2 hours before the procedure – stop drinking clear liquids.
Medicines
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Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
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Taking medicines such as aspirin and NSAIDs. These medicines can thin your blood. Do not take these medicines unless your healthcare provider tells you to take them.
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Taking over-the-counter medicines, vitamins, herbal medicines and supplements.
General instructions
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Do not use any products that contain nicotine or tobacco for at least 4 weeks before the procedure. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your healthcare provider.
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Imaging tests of your arm may be done to find the best place for the fistula.
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Plan to have a responsible adult take you home from the hospital or clinic.
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Ask your healthcare provider:
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How your surgical site will be marked.
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What steps will be taken to help prevent infection. These steps may include:
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Removing hair at the surgical site.
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Washing skin with an antibacterial soap.
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Taking antibiotics.
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What happens during the procedure?
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An IV tube will be inserted into one of your veins.
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You will be given one or more of the following:
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A medicine to help you relax (sedative).
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A medicine to numb the area (local anaesthetic).
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A medicine to make you fall asleep (general anaesthetic).
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A medicine injected into an area of your body to numb everything below the injection site (regional anaesthetic).
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An incision will be made on the inner side of your arm.
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A vein and an artery will be opened and connected with stitches (sutures).
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The incision will be closed with sutures or clips.
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A bandage (dressing) will be placed over the area.
The procedure may vary among healthcare providers and hospitals.
What happens after the procedure?
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Your blood pressure, heart rate, breathing rate, and blood oxygen level may be monitored until you leave the hospital or clinic.
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Your fistula site will be checked for bleeding or swelling.
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You will be given painkillers as needed.
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If you were given a sedative during the procedure, it can affect you for several hours. Do not drive or operate machinery until your healthcare provider says that it is safe.
Summary
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Arteriovenous (AV) fistula placement is a surgical procedure to create a connection between a blood vessel that carries blood away from your heart (artery) and a blood vessel that returns blood to your heart (vein). This connection is called a fistula.
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Follow instructions from your healthcare provider about eating and drinking before the procedure.
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Ask your healthcare provider about changing or stopping your regular medicines before the procedure. This is especially important if you are taking diabetes medicines or blood thinners.
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Plan to have a responsible adult take you home from the hospital or clinic.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
