People who develop advanced-stage kidney disease often need dialysis, in which a machine performs a basic function of the kidney: cleansing blood of impurities. Before a patient begins dialysis treatments, a minor surgical procedure called arteriovenous (AV) fistula might be recommended. Such a fistula – when an artery and vein are directly connected – also is an abnormality that in other circumstances might require surgical correction. But for someone has failing kidneys, surgically creating such a passageway can make the dialysis process easier.
In dialysis, all of a patient’s blood is withdrawn from an artery or vein, filtered and returned to a vein. Creating an AV fistula allows arterial pressure to enlarge the vein, over time, better enabling it to receive the volume of blood coming back into the body.
The vascular surgeon typically uses one of two surgical techniques:
- The basic procedure joins an artery to a vein, usually in the arm, though sometimes the fistula may be placed in the leg.
- For some patients with advanced vascular disease or who are very weak, or if the vein is blocked, the vascular surgeon might use an artificial graft to create the fistula.
Potential risks of arteriovenous (AV) fistula creation include:
- Clotting of the vessels involved
- Narrowing of the vessels in the fistula
- Aneurysm (weakening of the blood vessel)