What is an ArterioVenous Fistula

An arteriovenous fistula is created surgically in the arm by joining an artery and vein together either side by side or end to end. Fistula formation usually consists of a one/two-night stay in hospital, which will be arranged by your consultant. Post-surgery a fistula needs approx. 8-12 weeks before it can be used for your dialysis treatment. When used two needles are inserted into vessels branching from the fistula in your arm. One needle is for the arterial access (i.e. used for taking the blood out of your body to the dialysis machine) and another is for the venous access (i.e. used for returning the dialysed blood from the dialysis machine back to your body. The arterial needle is always placed closest to the surgical site.

A graft is a piece of man-made material often polytetrafluoroethylene that is surgically placed under the skin in your arm. Graft formation usually warrants a one/two-night stay in hospital. Grafts are ready to be used approx. three weeks’ post-surgery.

Medical and nursing staff in the hospital will provide more information to you when you are admitted for AV Fistula and Graft formation.

How do I care for my AV fistula /Graft?

The following points are important in caring for your AV fistula or graft:

• Never allow anyone to take blood (apart from dialysis personnel) or record your BP by using your fistula/ graft arm.
• Exercise your fistula/ graft arm by using your exercise/ stress ball regularly. For example, whilst sitting in a chair rest your arm to your side with the access side up and then roll your wrist up and down.
• Avoid wearing a watch, jewellery or tight clothing on your fistula/ graft arm as this can restrict blood flow.
• Nursing staff will show you how to check for the thrill (vibration). Do this every day getting in and out of bed to ensure that your fistula is working well.

If at any time, you notice that the thrill of your fistula or graft are absent ring Beacon Dialysis Unit during opening hours or your referring hospital renal unit for advice.

• Report any changes you may notice in your fistula/ graft to the staff in Beacon Renal i.e. unusual pain, numbness, redness/ abnormal bulging.
• If there is excessive bleeding post dialysis treatment or post-surgery when you are at home, apply pressure to the area with gauze/ clean cloth until the bleeding subsides. If the bleeding is excessive, please attend your local hospital.
• If bleeding is uncontrollable ring for an emergency ambulance (999 or 112). Always report such episodes to the staff in Beacon Renal at your next dialysis treatment.
• Avoid lifting very heavy objects especially in the initial period post-surgery as this can affect blood supply to your fistula/ graft.
• Avoid sleeping on your fistula or graft arm as this can restrict the blood supply to the fistula or graft.