On advice from a renal physician, it may be necessary for patients with poor kidney function to commence haemodialysis. An arteriovenous fistula (AVF) can be formed in the arm for this purpose. This operation usually involves a 5cm incision in the lower forearm or elbow crease. A suitable vein is joined to an artery with fine stitches. Patients stay overnight in hospital and the procedure can be performed under local or general anaesthesia. It usually takes around eight weeks after the operation for the AVF to grow sufficiently for haemodialysis use.
The maintenance of your AV fistula is vital for successful long-term dialysis. Surveillance protocols will be discussed after the AV fistula is made, but usually require a vascular surgery consultation every six months with imaging of the fistula to ensure there are no narrowings developing. If this occurs, it should be addressed promptly. Options include balloon angioplasty or open surgery to widen the calibre of the AV fistula.