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Fistula (Arteriovenous AVF)

A permanent vascular access created by surgically connecting an artery and a vein in your arm. It is the healthiest access method for long-term dialysis.

Permanent vascular access Type
4–6 weeks Maturation
Lowest Infection risk

What Is a Fistula (Arteriovenous AVF)?

An arteriovenous fistula (AVF) is a surgical procedure performed to create vascular access for patients receiving dialysis. It is done by surgically joining the patient’s own artery and vein. The fistula created in this way allows blood to flow to the dialysis machine effectively and safely. One of the greatest advantages of an AVF is its lower risk of infection, since it is made from the body’s own vessels. Because it is long-lasting and suitable for repeated use, it is considered the gold standard for dialysis patients.

Creating a Fistula (AVF)

An arteriovenous fistula (AVF) is a natural cannulation point created by surgically joining an artery and a vein. The procedure is usually performed under local anesthesia and provides effective vascular access for dialysis treatment.

Compared with other vascular access methods, an arteriovenous fistula lasts longer, causes fewer complications and carries a lower risk of infection. Because it is made from the body’s own vessels, it is natural and safe.

Fistula (Arteriovenous AVF) Care

Regular checks of the fistula are essential for detecting early signs of blockage or infection. Keeping the fistula area clean and dry also helps optimize blood flow.

Fistula (Arteriovenous AVF) Maturation

After the fistula is created, a “maturation” period of several weeks or months is usually needed. During this time, the fistula strengthens and becomes ready for use in dialysis.

Are There Risks to an AVF?

Is this treatment right for you? Our specialist physicians will assess your case and decide on the best method together with you.

Frequently Asked Questions

Questions about Fistula (Arteriovenous AVF)

If you can’t find the answer you are looking for, you can ask our team directly.

All questions

Answers are for general information only; please consult your physician for diagnosis and treatment.

What is an arteriovenous fistula (AVF)?

An arteriovenous fistula is a type of vascular fistula that creates a direct connection between an artery and a vein. This type of fistula allows blood to flow more quickly from the artery into the venous system.

Why is a fistula created?

An AVF is generally used in kidney dialysis. It creates a point where the dialysis machine can be connected to the bloodstream. This allows blood to be drawn into the machine, cleaned and then returned to the body during dialysis.

What is the difference between a fistula and a catheter?

A fistula (AVF) is a permanent vascular access created by surgically joining an artery and a vein in your arm. It takes a few weeks to mature; in the long term it is the healthiest method with the lowest risk of infection.

A catheter (CVC), on the other hand, is a temporary access placed in a large vein in the neck or chest that can be used immediately. It is preferred in emergencies or until a fistula matures.

How is a fistula created?

An AVF can be created with a surgical procedure or with endovascular techniques. During surgery, an artery and a vein are joined directly. In endovascular procedures, the vessels are usually accessed from the inside using a catheter.

How do I care for my fistula?

Regular care is important to keep an AVF healthy. This includes checking blood flow in the fistula area, keeping the area clean and detecting potential complications early.

Are there situations in which a fistula cannot be used?

In some cases, creating an AVF may be difficult due to specific conditions in the vascular system. In such cases, alternative vascular access options may be considered.

How soon after surgery can a fistula be used?

It usually takes a few weeks to a few months for a fistula to become strong enough to be used for dialysis, that is, to “mature”. For this reason, it is recommended to create the fistula before the expected start date of dialysis.

What should I avoid with my fistula arm?

Do not have your blood pressure measured, blood drawn or an IV line inserted in your fistula arm. Avoid carrying heavy loads, sleeping on the arm for long periods, and wearing tight watches, bracelets and clothes with tight sleeves.

How do I check that my fistula is working?

When you place your fingertips lightly on the fistula area, you should feel a vibration called a “thrill”. It is recommended to check this every day, preferably in the morning and evening.

What should I do if I can’t feel the vibration in my fistula?

If the vibration disappears or decreases noticeably, it may indicate that the fistula is blocked. This is urgent; call our center without delay or go to the nearest emergency department. Early intervention increases the chance of saving the fistula.

Should I do fistula exercises?

If your physician recommends it, exercises such as squeezing a soft ball at regular intervals after surgery can help the fistula develop. Always ask your physician when and how to start exercising.

What should I do if there is redness or swelling at the fistula site?

Redness, warmth, discharge, pain or fever may be signs of infection. If you notice these signs, contact your team without waiting for your next session.

Can I wash my fistula arm?

Yes. Washing the fistula area every day with warm water and soap reduces the risk of infection. It is recommended that you wash your arm before the session and keep the area clean.

What is the difference between a fistula and a graft?

A fistula is created by joining the patient’s own artery and vein. A graft is an artificial tube placed between them when the vessels are not suitable. A fistula usually lasts longer and has a lower risk of infection.

How long can a fistula be used?

A well-cared-for fistula can be used without problems for many years. Daily checks, protecting the arm and early intervention in possible problems extend the life of the fistula.