Percutaneous AV Fistula creation

Percutaneous arteriovenous (AV) fistula creation is a minimally invasive procedure used to create permanent vascular access for hemodialysis in patients with chronic kidney disease or kidney failure. Unlike traditional surgical AV fistula creation, this technique uses specialized catheters and imaging guidance to connect an artery and a nearby vein without the need for a large surgical incision.

During the procedure, the physician inserts small catheters into blood vessels, typically through tiny punctures in the arm. Using ultrasound and fluoroscopic guidance, the artery and vein are brought together and connected with a specialized device, creating an AV fistula. Over the following weeks to months, the vein enlarges and strengthens as blood flow increases, making it suitable for repeated dialysis needle access.

Percutaneous AV fistula creation is typically performed under local anesthesia and often allows for less pain, minimal scarring, and a faster recovery compared with open surgery. Patients are monitored after the procedure and receive instructions on protecting the access site, performing hand and arm exercises if recommended, and recognizing signs of complications such as swelling, bleeding, infection, or changes in blood flow.

A successfully matured AV fistula is considered the preferred long-term vascular access for hemodialysis because it generally provides reliable blood flow and has a lower risk of infection and clotting than dialysis catheters. Regular follow-up appointments are important to monitor fistula development and ensure it is ready for dialysis use.