An arteriovenous fistula specifies this connection between an artery and a vein.
These are surgically created to enable long term, long-term dialysis for patients with kidney failure.
The main reason is that a fistula provides access to a vessel that has enough flow
When using haemodialysis, your blood volume is passed through a machine that washes the blood, removes waste products, and then replaces the blood into circulation.
To ensure your blood volume passes through the machine, you must have access to a vessel with a very high rate of flow that enables the machine to pump blood through the circuit quickly. If dialysis were done through veins only (for example, a vein in the forearm, similar to when you have blood taken), it would only be able to sometimes wash 20-30ml of blood per minute, depending on how big the vein was in your forearm. When undergoing proper haemodialysis, the machine typically runs at 300-400mls per minute, and it still takes 3-5 hours to wash your blood 3x a week thoroughly. If you could only wash 20-30ml per minute, you would never be able to dialyse fast enough.
Arteries have high flow rates but are extremely important as they provide segments of your body with blood. If arteries in your arms get damaged or blocked, you might not have enough blood left for your hand. They are also deep and can be hard to place needled in. Fistulas enable the veins under your skin (which you would typically get blood tests taken through) to have the same flow as the deeper arteries but with the safety of puncturing a vein
Fistulas have been made for countless years using open surgical techniques. There is a new method using minimally invasive techniques, which is discussed in the EndoAVF article.
The risks of fistula creation are low but can be severe.
Aneurysms of the fistula – after years of passing needles into the fistula, it can weaken the wall, and the fistula can bulge. It can turn from a 6mm to a 2cm diameter vessel. These can be surgically corrected if required.
Consulting locations
WOLLONGONG
Artery and Vein Clinic
402 Crown St
Wollongong
NSW 2500
GREGORY HILLS
Artery and Vein Clinic
Soma Centre
Suite 8/7, Gregory Hills drive
Gregory hills
NSW 2557
Orange
Artery and Vein Clinic
117 Molder st
Orange
NSW 2800
Contact Info
Wollongong
Phone: (02) 4226 9333
Fax: (02) 4229 4006
Gregory Hills
Phone: (02) 4601 1055
Fax: (02) 4601 1058
Orange
Phone: (02) 4601 1055
Fax: (02) 4601 1058
Healthlink EDI: wgvascul
Office Hours
9am – 4:30pm Monday to Friday
Phone Hours
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