Arteriovenous fistula formation
Arteriovenous fistulas are fashioned to provide a high-flow vessel that is easily accessible for haemodialysis in patients with chronic renal failure. Superficial veins from the upper limb such as the cephalic and basilica vein can be anastomosed to adjacent arteries. The fistula must then mature over the following 4 – 6 weeks before it can be used for dialysis.
Venous anatomy may be determined preoperatively using duplex ultrasound. The site should be marked preoperatively. An appropriate incision is made that allows access to both the vein and artery. The vein is dissected and mobilized towards the artery. The vessels are anastomosed with non-absorbable sutures.