Arteriovenous Fistula (AVF)

An arteriovenous fistula (AVF) is an abnormal connection between an artery and a vein, bypassing the tiny capillaries that normally slow blood flow. This condition can be congenital (present from birth) or acquired due to injury, surgery, or certain medical conditions. In some cases, AVFs are created surgically for patients undergoing hemodialysis, as they provide a reliable access point for blood filtration.

If left untreated, a problematic AVF can cause complications like swelling, pain, skin changes, heart strain, or reduced blood supply to tissues. Diagnosis usually involves ultrasound, CT angiography, or MRI to evaluate blood flow patterns. A Vascular & Endovascular Surgeon specializes in identifying the severity of the fistula and providing the most effective treatment tailored to the patient’s condition.

Types of Arteriovenous Fistula Treatments

1. Surgical Ligation

In surgical ligation, the surgeon closes the abnormal connection between the artery and vein. This is often recommended for AVFs causing significant symptoms or risk of complications. The procedure restores normal blood circulation and prevents further damage to surrounding tissues.

2. Endovascular Embolization

A minimally invasive option, endovascular embolization involves inserting a catheter into the affected blood vessel and releasing tiny coils, plugs, or special glue to block the abnormal blood flow. This method is ideal for AVFs located deep within the body or in delicate areas such as the brain or spinal cord.

3. Resection and Reconstruction

For complex AVFs, the surgeon may remove the affected blood vessel segment and reconstruct the artery or vein to restore healthy blood flow. This approach is usually reserved for larger or recurrent fistulas.

4. Creation of AVF for Dialysis Access

In patients with chronic kidney disease, a surgically created AVF in the arm is often the preferred vascular access for long-term hemodialysis. It provides a durable and high-flow connection, reducing the risk of clotting and infection compared to other access types.

5. Observation and Monitoring

In some small or asymptomatic AVFs, immediate intervention may not be necessary. Instead, the surgeon may recommend regular monitoring through imaging studies to ensure the fistula does not enlarge or cause complications.

Conclusion

An arteriovenous fistula requires timely diagnosis and management to prevent long-term complications. Consulting a qualified Vascular & Endovascular Surgeon ensures access to both surgical and minimally invasive treatment options, improving patient outcomes and quality of life.