If  you have chronic kidney failure and need dialysis, you’ll first have a procedure to create a permanent access to your bloodstream (called vascular access surgery). This allows for a life-saving connection to the dialysis machine, which removes any toxins and other waste from your body.

The vascular surgeons at McKenzie-Willamette Medical Center specialize in the two main types of access procedures: arteriovenous (AV) fistula and (AV) graft. Your surgeon will work closely with you and your nephrologist to decide which option is best for your long-term needs.

Learn more about AV fistula below, and be sure to see our page on AV Grafting to help understand the differences.

About the Procedure

During arteriovenous (AV) fistula surgery, your surgeon takes a piece of a vein from your arm or leg and connects it to a nearby artery with a small incision. The vein grows wider and thicker over time, allowing the largest amount of blood flow to pass through the dialysis machine.

After the procedure, it usually takes three to six months for the fistula to fully form and be ready for use. Your surgeon and nephrologist will ensure your procedure is scheduled well before you start dialysis. If your kidney disease has progressed quickly, you may need a venous catheter (thin, flexible tube) as a temporary access until your graft is placed.

AV Fistula Compared to AV Grafting

Since AV fistula uses your body’s natural tissues, it has a lower risk of infection compared to AV grafting, which uses man-made materials. Though it does take longer to “mature” for use compared to grafting, it is generally the preferred choice because it tends to have fewer problems and enables better blood flow. Grafts are typically recommended if your veins are too small for fistula.

Recovery & Follow-Up Care

AV fistula surgery is usually done on an outpatient basis with a local anesthetic and/or light sedative, allowing you to go home the same day and recover comfortably at home.

Since the access point is your lifeline, you’ll receive important instructions for cleaning and caring for it. Proper care helps ensure fewer problems with a better functioning and longer-lasting access. To help strengthen your fistula and speed healing, we may recommend exercises such as squeezing a rubber ball.

At McKenzie-Willamette Medical Center, your dedicated team is always here to answer questions and ensure your fistula is working well, so you can feel your best.