AV Fistula

What is an AV fistula?

An arteriovenous (AV) fistula is an abnormal passageway between an artery and a vein. Although it most often occurs in the legs or arms, an AV fistula can occur anywhere in the body, including the brain. An AV fistula may also be created to provide an access for hemodialysis in people with end-stage kidney failure.

Normally, your blood flows from arteries through capillaries and back to your heart in veins. When an AV fistula is present, blood flows directly from an artery into a vein, bypassing the capillaries. If the volume of diverted blood flow is large, tissues downstream receive less blood supply. In addition, heart failure may occur due to the increased volume of blood returned to the heart.

A doctor may suspect an AV fistula by an abnormal sound (bruit) heard over the artery with a stethoscope. The sound is due to turbulent blood flow between the artery and the vein.

What can I expect during this procedure?

An interventional radiologist creates an AV fistula by connecting an artery directly to a vein, usually in the forearm. Connecting the artery to the vein causes more blood to flow into the vein. As a result, the vein grows larger and stronger, making repeated insertions for hemodialysis treatments easier. For the surgery, you'll be given a local anesthetic. In most cases, the procedure can be performed on an outpatient basis.