What is an Arteriovenous Fistula? (Also known as an AVF)

An AV fistula is a connection, made by a vascular surgeon, of an artery to a vein.  Arteries carry blood from the heart to the body, while veins carry blood from the body back to the heart.

Vascular surgeons specialize in blood vessel surgery and creation of AVF and arteriovenous grafts (AVG).  AV F and AVG are typically placed in the forearm or upper arm.

An AVF causes extra pressure and extra blood to flow into the vein, making it grow large and strong. The larger vein provides easy, reliable access to blood vessels. Without this kind of access, regular hemodialysis sessions would not be possible because untreated veins cannot withstand repeated needle insertions. They would collapse the way a straw collapses under strong suction.

  • A surgeon performs AV fistula surgery in an outpatient center or a hospital. The vascular access procedure may require an overnight stay in the hospital; however, many patients go home afterward.
  • An AV fistula frequently requires 2 to 3 months to develop, or “mature,” before it is ready to be used for hemodialysis.  If an AV fistula fails to mature after surgery, a surgeon must repeat the procedure.

What is an arteriovenous graft? (Also known as an AVG)

An AV graft is a looped, plastic tube that connects an artery to a vein. A vascular surgeon performs AV graft surgery, much like AV fistula surgery, in an outpatient center or a hospital. As with AV fistula surgery, the patient may need to stay overnight in the hospital, although many patients can go home after the procedure. A health care provider uses local anesthesia to numb the area where the surgeon creates the AV graft.

  • A patient can usually use an AV graft 3 – 4 weeks after the surgery.  An AV graft is more likely than an AV fistula to have problems with infection and clotting; however, a well-cared-for graft can last several years.