AV Fistula Surgery – Reliable Access for Life-Saving Dialysis

For people on hemodialysis, a dependable vascular access is as vital as the treatment itself. An arteriovenous (AV) fistula connects a native artery to a vein, creating a strong, high-flow channel that can be accessed repeatedly with fewer complications than temporary lines.

Why AV Fistula?

Compared to catheters and grafts, AV fistulas generally offer better longevity, lower infection risk, and improved dialysis efficiency once they mature. We work with you to select the optimal site (often non-dominant forearm) and plan your access well before dialysis begins.

How We Help – From Planning to Patency

1) Pre-operative Mapping and Counseling

We perform ultrasound vessel mapping to identify suitable arteries and veins. Our team explains the procedure, expected timeline to maturity, and how to protect your future access.

2) Expert Surgical Creation

Through a small incision under local or regional anesthesia, we connect the vein and artery with meticulous technique to promote rapid maturation. Most patients go home the same day.

3) Maturation Support and Monitoring

We follow a structured maturation program: physical exam, Doppler checks, and readiness testing. Exercises like gentle fist-clenching may be recommended to help the vein enlarge.

4) Salvage and Repairs

If maturation is delayed, we evaluate for treatable causes (stenosis, competing branches) and perform endovascular or surgical interventions to rescue the access where appropriate.

Living With Your Fistula – Practical Tips

• Keep the access arm clean; avoid tight clothing or jewelry over the site.
• Do not allow BP measurements, IV lines, or blood draws from the fistula arm.
• Check for the “thrill” (vibration) daily and report any change immediately.
• Protect from trauma; don’t sleep on or carry heavy loads with the fistula arm.

Expected Timeline

• Day 0–1: Discharge with wound care instructions
• Week 1–2: First review and Doppler assessment
• Week 4–8: Most fistulas are ready for dialysis cannulation once adequately matured

Insurance and Financials

Most health plans cover AV fistula surgery when medically indicated for dialysis access. We help with pre-authorization, paperwork, and transparent estimates.

When to Seek Urgent Care

Redness, warmth, fever, sudden pain, absent thrill, swelling of the hand, or bleeding that does not stop with pressure are red flags—contact us immediately.

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This guide is adapted and rewritten from authoritative patient resources to be easy to read and act on, including the overview from Pristyn Care on AV fistula.