The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Arteriovenous Fistula for Haemodialysis

The preferred long-term vascular access for patients needing haemodialysis.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Arteriovenous Fistula for Haemodialysis?

An arteriovenous (AV) fistula is a permanent vascular access for patients on haemodialysis. An artery — usually the radial or brachial — is connected to a vein (cephalic or basilic), allowing high-pressure arterial blood to enter the vein so that it enlarges and thickens (maturation) enough for dialysis needling.

KDOQI and European guidelines advocate a ‘fistula-first’ strategy: AV fistulas are associated with lower infection rates, longer patency and lower morbidity and mortality than catheters or AV grafts. Ideally the fistula is created at least 3–6 months before dialysis is expected to start.

Common types are the Brescia–Cimino fistula (wrist, radial artery to cephalic vein), the brachiocephalic fistula and the brachiobasilic transposition. Maturation takes 6–12 weeks, and preoperative vessel mapping greatly increases success.

Symptoms

Palpable thrill over the fistula
Bruit on auscultation
Visible dilation of the arm vein (maturation)
Mild post-operative arm swelling
Pressure or discomfort at the fistula site
Redness, warmth or pain if infected
Loss of thrill and bruit in a failed fistula

Risk Factors

Diabetes (affects vessel quality)
Peripheral arterial disease
Advanced age
Prior failed AV access attempts
Obesity (deep veins)
Central vein stenosis or thrombosis
Female sex (smaller vessels)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Loss of thrill (suspected thrombosis)
  • Redness, warmth or discharge (infection)
  • Severe arm swelling and pain
  • Signs of heart failure (high-flow fistula)
  • Cold, pale, painful hand (steal syndrome)

Treatment Methods

01
Preoperative vessel mapping and site selection
02
Radiocephalic fistula (first choice): wrist end-to-side anastomosis
03
Brachiocephalic fistula: elbow-level brachial artery to cephalic vein
04
Brachiobasilic transposition: superficialising the deep basilic vein
05
Balloon angioplasty or surgical revision for non-maturing fistulas
06
Management of thrombosis, stenosis, aneurysm and steal syndrome

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Genel Cerrahi Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Appendicitis

Genel Cerrahi

Appendicitis is inflammation of the appendix causing severe pain in the lower right abdomen. Early diagnosis and surgical treatment are life-saving.

Inguinal Hernia

Genel Cerrahi

Inguinal hernia is the protrusion of intestine or fat into the inguinal canal due to weakness in the abdominal wall. It can be permanently corrected with surgical treatment.

Umbilical Hernia

Genel Cerrahi

Umbilical hernia manifests as a soft swelling around the navel. While it often resolves spontaneously in infants, surgical treatment may be required in adults.

Gallstones and Cholecystectomy

Genel Cerrahi

Gallstones cause severe pain in the upper right abdomen, especially after fatty meals. They are safely treated with laparoscopic cholecystectomy.

Hemorrhoids (Piles)

Genel Cerrahi

Hemorrhoids result from swelling of the veins in the anus; they present with blood on toilet paper, itching, and pain. Various treatments are available, from lifestyle changes to surgery.

Anal Fissure

Genel Cerrahi

Anal fissure is a tear in the thin skin of the anal canal. It presents with sharp pain and bleeding and can be healed with medical or surgical treatment.

Pilonidal Sinus

Genel Cerrahi

Pilonidal sinus consists of tunnels and tracts prone to chronic infection, formed by hair becoming embedded under the skin in the tailbone area. Surgical treatment provides a permanent solution.

Thyroid Surgery

Genel Cerrahi

Thyroid surgery involves the removal of part or all of the thyroid gland for indications such as benign nodules, goiter, and thyroid cancer.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.