The diagnosis of CKD is associated with the need for dialysis, for which, accordingly, there must be vascular access. An option for such access is the AV fistula, which is considered as the best choice, as it usually lasts longer and creates fewer problems.
AV fistula is a surgical connection made between an artery and a vein created by a vascular specialist. It is usually located in the arm, but if this is not possible, it can be placed in the groin or in the legs. With an AV fistula, blood circulates from the artery directly into the vein, delivering the right amount of blood flow needed to provide adequate hemodialysis treatment. AV fistulas are the preferred vascular access for long-term dialysis because they have fewer complications than other access methods and are less prone to infections and thrombosis. The fistula will take several weeks to mature, with an average period of 4-6 weeks.
Some of the benefits of AV fistula is that it provides the necessary blood flow needed for effective dialysis, which can help reduce treatment time, lower the risk of infection, and reduce the likelihood of clotting.
How is an AV fistula created?
The first step in creating an AV fistula is to assess the condition of the blood vessels (veins and arteries). These manipulations and examinations are performed by a vascular specialist. If necessary, minimally invasive tests such as ultrasound and possibly an angiogram can be used to determine the size and depth of the arteries and veins. These tests will determine if the blood vessels are able to support the AV fistula. The procedure is performed on an outpatient basis using local anesthesia. Once the AV fistula is established, it will take several weeks, in some cases a month or more, for the fistula to mature to the point where it can be used for hemodialysis treatment.