AV Fistula

About AV Fistula at Kayakriti

Patients with end-stage kidney disease rely on dialysis to remove toxins that the kidneys can no longer clear. Sustainable dialysis depends on stable, repeatable access to the bloodstream. The AV fistula, created surgically by joining an artery to an adjacent vein, is widely regarded as the gold standard for this purpose because of its longevity and lower long-term infection risk compared with central venous catheters or synthetic grafts.

At Kayakriti, dialysis fistula creation is performed with attention to the individual anatomy of each patient. Most fistulas are formed in the forearm, often at the wrist, but elbow-level fistulas may be planned where forearm vessels are unsuitable due to repeated venepuncture. Pre-operative assessment includes clinical mapping of arteries and veins and, where necessary, duplex ultrasound to choose the most promising site for vascular access surgery.

The procedure is typically performed under local or regional anaesthesia, avoiding the additional risks of general anaesthesia for patients who often have multiple comorbidities. After surgery, the connected vein gradually thickens and dilates over several weeks, a process known as maturation. Once mature, it can be reliably cannulated for kidney dialysis treatment, supporting the high blood flow rates needed by modern dialysis machines.

Compared with other access options, a well-formed AV fistula offers improved blood flow, fewer infections, and a longer functional lifespan. However, success depends on the condition of the patient's vessels, glycaemic control, and careful post-operative care. We discuss realistic expectations openly, including the possibility that an alternative site may be needed if the first attempt does not mature, and we explain the warning signs that should prompt early review.

What people in Lucknow ask us about: dialysis fistula creation · vascular access surgery · kidney dialysis treatment