Dialysis Fistula

A vascular surgeon performs dialysis fistula surgery. Vascular surgeons diagnose and treat conditions that affect your blood vessels, including arteries and veins.

During dialysis fistula surgery, your care team will:

• Give you a local anesthetic to numb your treatment area and a sedative through a peripheral IV to help you relax.
• Use a surgical knife (scalpel) to make a small cut (incision) in your treatment area — usually in your arm, with your elbow or wrist as the best locations.
• Clamp a small section of your artery.
• Use the scalpel to cut small areas of your artery and vein.
• Sew the vein into the clamped section of your artery.
• Release the clamps.
• Ensure blood flows through your vein and that there isn’t any bleeding.
• Close your incision with dissolvable stitches (sutures).

Dialysis fistula surgery usually takes one to two hours to complete.

An AV fistula must heal for at least a few months before it’s ready for hemodialysis. A healthcare provider may also recommend stress ball exercises to help strengthen and expand your fistula.

The fistula will look like a large vein under your skin. You should check your blood flow daily by feeling for a vibration, which may feel like a purring cat. Some describe the vibration as a buzz, pulse or trill. Once you heal, you should be ready for hemodialysis.

During hemodialysis, a hemodialysis nurse or technician will insert two needles in the “strike zone” of your engorged vein. One is an “arterial” (artery) needle that removes blood from your body and sends it to the hemodialysis machine. The machine then sends your clean blood back into your body through the second “venous” (vein) needle.

The needle in the arterial side removes blood from your body and sends it to a hemodialysis machine. The machine sends your clean blood back into your body through the needle in the venous side.

A dialysis fistula isn’t usually permanent. But it can last for many years.

To help protect your fistula and make it last as long as possible, you should avoid:

• Sleeping on your access area
• Wearing tight clothing or jewelry that may squeeze the area
• Using a cuff on your affected arm to check your blood pressure
• Having blood drawn from your affected arm

It’s also a good idea to wear medical alert jewelry, like a bracelet or necklace, to inform providers about your dialysis fistula. You can also add emergency information on your smartphone’s lock screen. Some people also choose to get a medical alert tattoo on their arm.