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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.