An arteriovenous fistula (AVF) surgery is a medical procedure primarily conducted to facilitate efficient hemodialysis
for patients with chronic kidney disease or end-stage renal failure. This surgery involves creating a direct connection
between an artery and a vein, usually in the arm. The purpose is to prepare a patient’s vascular system for the
regular access required for hemodialysis, a treatment to filter and purify the blood when the kidneys are no longer
functional.
The surgical creation of an AVF is typically a planned procedure and is considered the gold standard for vascular
access in hemodialysis patients. It is preferred over other types of access, like arteriovenous grafts or central venous
catheters, due to its lower infection rates and longer lifespan. During the procedure, a vein is connected to a nearby
artery, usually in the forearm. This connection causes more blood to flow into the vein, making it grow larger and
thicker. This process, known as maturation, takes several weeks to months, after which the vein can be used for
hemodialysis.
The benefits of an AVF include a lower risk of infections and clotting compared to other types of dialysis access, and
with proper care, it can last for many years. However, the surgery does pose the risks of bleeding, infection, and the
possibility of the fistula not maturing adequately. Additionally, patients may experience steal syndrome, a condition
where the fistula diverts too much blood from the hand, causing pain and numbness.
Postoperative care is crucial for the success of an AVF. Patients are advised to protect the arm where the fistula was
created, avoiding heavy lifting or pressure on that arm. Regular follow-ups with the surgical team are essential to
monitor the fistula’s maturation and function.