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AV Fistula Treatment

AV fistula, or arteriovenous fistula, is a condition in which an artery makes an abnormal connection to a vein. In some cases, AV fistula is a disease process requiring correction for proper body function. In other cases, it is a surgically created condition used to further treatment of other diseases. Discussion of AV fistula treatment requires a clear distinction between these two topics.

  1. Understanding Harmful AV Fistula

    • Harmful AV fistula most commonly occurs in the lungs, where it is referred to as pulmonary AV fistula. In this form of fistula, blood that would normally be enriched with oxygen leaves the lungs before this process can occur, leading to potential oxygen starvation in the body. In many cases, this blood bypass is not severe enough to cause problems, but oxygen loss can lead to complications including breathing difficulties; blue, enlarged or puffy fingers and toes; decreased stamina; and infection or abscess of the heart valves. It may also lead to the formation of blood clots that can travel to the brain, legs or arms.

    Treating Harmful AV Fistula

    • If you suffer from pulmonary AV fistula, you may be entirely unaware of your circumstances. Even if its presence is known, you may not need medical intervention. However, you will likely require treatment to correct your condition. The least invasive method of treating pulmonary fistula is called embolization. In this procedure, a catheter is used to place material in the affected blood vessel to effectively block off its blood supply, leading to a non-surgical bypass of the fistula. While this procedure is effective, the blocking material sometimes slips, allowing the fistula to re-engage. As a result, some doctors opt for surgery to directly remove the abnormal vessel. Some surrounding lung tissue is typically removed at the same time.

    Purposeful AV Fistula

    • Purposeful AV fistulas are used as a way to create improved access to the body's blood supply. This is typically done during the course of long-term dialysis, or artificial cleansing of the blood. If you receive dialysis for chronic kidney disease, you may be a candidate for this procedure. Artificial fistulas are most commonly located in the forearm. To create one, surgeons will take one of your arteries and attach it directly to a nearby vein, thereby greatly increasing blood flow in the vein. This increased blood supply significantly strengthens and enlarges your vein, making it more resilient and able to withstand the repeated needle intrusions that come with regular dialysis.

      Surgery for AV fistula creation is usually done under local anesthetic on an outpatient basis. Once the procedure is performed, it may take a number of months for the new fistula to gain sufficient strength for use. In some instances, the veins of the arm may be too delicate to form a good fistula. If this is the case you may receive an AV graft, which involves placing a synthetic tube under the skin to allow vein access. If you require dialysis treatment before a fistula can be properly formed, you may receive a temporary catheter in your leg, chest or neck.

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