Strong Heart and Vascular Center

Division of Vascular Surgery

Arteriovenous (A-V) fistula

If you are a patient who needs hemodialysis (link to kidney diseases, dialysis) treatment, you’ll need a blood access with good blood flow that can be used over and over again. Your access is a point of entry into your bloodstream so we can connect you to the dialysis machine. It’s the only way we can treat you with effective, repeated dialysis.

Our vascular surgeons can create a blood access for you called a fistula, which will be used for the long-term. We create the fistula with a small operation to join one of your arteries with one of your veins (usually in the arm, wrist, or upper forearm). This allows arterial blood to flow directly into the vein.

In the best cases, we can directly connect your artery to a vein. In older patients or those with smaller vessels, we may need to use an artificial graft to create the fistula.

You might notice some mild bruising or swelling at the fistula site the next day after surgery.

Because of the pressure from the artery, over a month or two following the operation, the vein will get bigger and its wall will get thicker. This prepares the vein to manage high blood flow rates and repeated needle sticks.