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A fistula is surgically created by connecting an artery and a vein in the arm. The vein (superficial, and easily accessible) will therefore be arterialised.
Thus, its size increases, its wall thickens and it becomes visible under the skin. And this facilitates the puncture and the pumping of a sufficient amount of blood (300 ml/ minute).
The passage of blood through the fistula is perceived upon palpation as a quiver (also called «thrill»).
The arteriovenous fistula is the preferred vascular access thanks to:
The Fistula can be located either on the forearm or on the upper arm. It is preferable to be located on the non-dominant arm, that is to say the left arm for righthanded people, and vice versa, because it is the arm least used in the everyday life.
The intervention is performed under loco-regional anaesthesia (only the arm), in the operating theatre. It lasts about one hour. At any time, you can contact the nurse and advise of any discomfort. In rare case, the intervention is performed under general anaesthesia.
Upon your return from the operating theatre, the nurse will be monitoring your bandage and the proper operation of your fistula. The creation of the latter requires a 24 hours hospitalisation.
The fistula requires a few weeks or even a few months to develop properly, namely to set a flow rate which is sufficient for the haemodialysis. The proper operation of your arteriovenous fistula is a determining factor of the effectiveness of the dialysis. It is therefore very important to take precautions to protect your fistula, in order to keep it in the best possible condition.
You must avoid:
Do now allow that they measure your blood pressure or draw blood from the arm where the fistula is placed.
The arteriovenous fistula is the preferred vascular access. It is therefore important to protect it against any risk for trauma: