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Arteriovenous Fistula Creation for Hemodialysis

Medically reviewed by Last updated on Jul 4, 2022.

What do I need to know about an arteriovenous fistula (AVF) creation?

An AVF creation is surgery to connect an artery to a vein. This surgery is done so you can receive hemodialysis. The AVF is usually placed in your forearm or upper arm.

How do I prepare for an AVF creation?

  • Your surgeon will talk to you about how to prepare for surgery. You may need an ultrasound of your arm before surgery. An ultrasound will help your surgeon decide which artery and vein he will use to create your AVF. You may need to stop taking blood thinners 1 week before surgery.
  • Your surgeon may tell you not to eat or drink anything after midnight on the day of your surgery. He will tell you what medicines to take or not take on the day of your surgery. You may be given an antibiotic through your IV to help prevent a bacterial infection. Tell a healthcare provider if you have ever had an allergic reaction to an antibiotic. Ask someone to drive you home and stay with you after surgery.

What will happen during an AVF creation?

You may be given general anesthesia to keep you asleep and free from pain during surgery. You may instead be given local or regional anesthesia to numb the surgery area. With local or regional anesthesia, you may still feel pressure or pushing during surgery, but you should not feel any pain. Your surgeon will make an incision in your arm. He will connect your artery and vein with stitches. Your incision will be closed with stitches and covered with a bandage.

What will happen after an AVF creation?

  • Healthcare providers will monitor you until you are awake. They will feel the area over your AVF for a thrill, and listen for a bruit. A thrill is a vibration, and a bruit is a humming noise. The presence of a bruit and a thrill mean that blood is moving through your AVF properly. A healthcare provider will show you how to feel for a thrill.
  • Your arm may feel sore for several days after your surgery. You may have mild bruising or swelling near your wound. Your wound may drain a few drops of blood or pink fluid for 24 hours. Your AVF will take 2 to 3 months to heal. After this time, it can be used for hemodialysis.

What are the risks of an AVF creation?

You may bleed more than expected or get an infection. Your AVF may become narrowed or blocked. This may slow or stop blood flow through your AVF, or to your arm or hand. You may need surgery to fix this or create another AVF. You may get a blood clot in your arm or leg. This may become life-threatening.

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