At NIHS Clinic, we specialize in the creation and management of arteriovenous (AV) fistulas, offering patients a safe and effective vascular access solution for long-term hemodialysis. Our team of skilled vascular surgeons uses advanced techniques to provide optimal outcomes, with a focus on patient comfort and long-term fistula durability. With a personalized approach, each procedure is carefully planned to meet the unique needs of our patients, ensuring both safety and efficacy.

What is an AV Fistula?

An arteriovenous (AV) fistula is a surgically created connection between an artery and a vein, typically in the arm. This connection allows for increased blood flow to a vein, which over time becomes stronger and larger, making it suitable for the repeated needle insertions required in hemodialysis. At NIHS Clinic, we use the latest techniques to create high-quality AV fistulas, ensuring that patients receive reliable and effective access for dialysis.

Why is an AV Fistula Performed?

AV fistulas are a preferred option for vascular access in patients who require long-term hemodialysis, as they offer a number of advantages over other forms of access, such as central venous catheters or AV grafts. At NIHS Clinic, AV fistulas are commonly created for the following reasons:

Reliable Vascular Access for Hemodialysis

• Purpose: Provides a dependable and durable vascular access point for hemodialysis, facilitating efficient blood filtration.
• Who Needs It: Patients with chronic kidney disease or end-stage renal disease (ESRD) who require ongoing hemodialysis.
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Reduced Risk of Infection

• Purpose: Minimizes the risk of infection compared to central venous catheters, as the fistula is created from the patient's own tissue.
• Who Needs It: Individuals who are at higher risk for infections due to regular dialysis treatments.
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Improved Blood Flow

• Purpose: Allows for higher blood flow rates, resulting in more effective dialysis sessions and reduced complications.
• Who Needs It: Dialysis patients who require efficient blood filtration for improved health outcomes.
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Types of AV Fistula Procedures Offered at NIHS Clinic

Radiocephalic AV Fistula

• Purpose: Connects the radial artery and cephalic vein in the forearm, creating a natural access point for hemodialysis.
• Uses: Often chosen for patients with good vascular health, this fistula type is durable and commonly used in dialysis.
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Brachiocephalic AV Fistula

• Purpose: Joins the brachial artery to the cephalic vein in the upper arm, providing a high-flow access option.
• Uses: Suitable for patients needing a larger vessel, especially when forearm veins are not viable.
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Transposition and Grafting Techniques

• Purpose: Enhances the placement and usability of veins in cases where veins need to be transposed or when grafting is required.
• Uses: Beneficial for patients with complex vascular anatomy or insufficient vein size.
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Preparation for AV Fistula Surgery

General Preparation:

• Assessment: A preoperative vascular evaluation is conducted to determine the best location and type of fistula for each patient.
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• Medications: Patients may need to adjust certain medications prior to surgery, as advised by the clinic.
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• Dietary Restrictions: While fasting is usually not required, specific instructions will be provided during pre-surgery consultations.
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Procedure Details

Process:

• Anesthesia Application: Local or regional anesthesia is applied to numb the area, ensuring patient comfort throughout the procedure.
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• Fistula Creation: The surgeon carefully connects the artery and vein, typically in the forearm or upper arm, to allow high blood flow for dialysis.
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• Closure and Dressing: The site is closed with sutures and dressed to aid in healing and protect the area.
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Safety and Risks

• Safety: AV fistula creation is a generally safe procedure, performed in a sterile environment by qualified professionals.
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• Risks: Potential risks include bleeding, infection, or delayed maturation of the fistula. Detailed post-procedure care instructions are provided to minimize complications.
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Post-Procedure

Recovery:

• Patients are typically able to return home the same day with care instructions to support fistula maturation and healing.
• Follow-up appointments are scheduled to monitor fistula development and ensure readiness for dialysis.
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Results:

• Maturation Timeline: An AV fistula usually takes 6-12 weeks to mature before it can be used for dialysis.
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• Follow-Up Care: Regular assessments will be scheduled to confirm fistula function and address any issues.

Benefits of AV Fistula Creation at NIHS Clinic

• Long-Term Durability: AV fistulas generally provide the longest-lasting access for dialysis, minimizing the need for additional interventions.
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• Reduced Complications: By using the patient’s own blood vessels, the AV fistula minimizes infection risk, improving safety and comfort.
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• Customized Solutions: Our specialists evaluate each patient’s unique needs to determine the most suitable fistula type and placement.
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• Experienced Professionals: With a team of skilled vascular surgeons and modern facilities, NIHS Clinic ensures quality care with reliable, effective outcomes.
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At NIHS Clinic, we’re committed to providing exceptional care for patients requiring vascular access. Contact us to learn more about our AV fistula services and to schedule a consultation with our dedicated vascular team.