AVF-

ATRIOVENTRICULAR
FISTULA
DEFINATION:

• It is a subcutaneous anastomosis of an artery and vein, allowing blood flow

which directly moves from artery to vein.
• AVF is a continuous circuit.

OUTFLOW HEART INFLOW CONNECTION VEIN

(VEIN) (ARTERY) ANASTOMOSIS
RADIAL ARTERY AND CEPHALIC VEIN FISTULA

SITES OF
ANASTOMOSIS

BRACHIAL ARTERY AND CEPHALIC VEIN FISTULA

INDICATIONS: • For end stage renal disease caused due to
underlying disease like diabetes and
hypertension.
• In the inability of the kidney to filtrate.
• Renal failure requiring chronic
hemodialysis.

PREPARATION :
❑ Doppler ultra sound is performed to map the bloodvessels.
❑ If allergic inform the doctor beforehand.
❑ If any intake of medications inform the doctor.
❑ Avoid eating and drinking on the day prior to the surgery.
 • Skin should be cleaned with aseptic solution.
• Local anaesthesia should be administered to numb
the area.
• Incision should be done on the selected area.
PROCEDURE: • The selected vein should be incised and connected
to the artery surgically by suturing.
• Then the skin incision is closed with
the sutures and bandage is placed over
the incision.
PROCEDURE
STEP WISE.
RECOVERY AND POST
PROCEDURAL CARE :
• Can be performed in outpatient setting
also
• Surgery can be done and patient can be
discharged in few hours.
• Medication will be given for post
operative pain.
• Advised to keep the arm elevated to
reduce swelling.
• It takes 2-3
months until the fistula is matured and
capable of hemodialysis.
 • Washing the vascular access site everyday.
• Ensure that doctor checks the access
site before every hemodialysis.
• Using the access site for only dialysis and not
any other procedure.

PRECAUTIONS • Do not bump or injure the access site .

• Check for thrill i.e a rhythmic vibration which
TO PROTECT indicates the AVF site is healthy .
• Do not put on the BP cuff on the access site

THE SITE: of arm.

• Do not lift heavy objects with access arm.
• Avoid sleeping on access arm.
• Report infections like redness ,swelling , pus
drainage to doctor immediately if seen.
 • Excess bleeding.
• Pain.
RISK AND • Swelling.
COMPLICATIONS: • Infections.
• Formations of clots- that block
the AV Fistula.
FISTULA
MATURATION:
• RULE OF
6'S:

6WEEKS OLD
6MM DEEP.
6NM FISTULA DIAMETE
600 ML PER MINUTE BLOOD
FLOW.
BENEFITS AND USES :
• Can be used for a longer time compared to other
types of vascular access.
• No foreign material is implanted into the body .
• Optimized blood flow for effective hemodialysis
while minimizing treatment time.
• Lower's infection risk.
• Can be performed in OP setting.
• Ensures faster recovery.