• ⦿ An Arteriovenous Fistula (AVF) is direct communication between an artery and a vein. It is considered as an abnormality when it happens spontaneously in the body. But for the purpose of long-term hemodialysis, this communication is deliberately created as a surgery.

• ⦿ During haemodialysis, blood is drawn out of the body, cleaned by the artificial kidney called dialyzer mounted on a dialysis machine and returned to the body. This process requires a supply of a fairly large quantity of blood (around 200ml per minute) to the dialyzer for efficient dialysis. The blood flow in a normal vein is very much less. By creating this surgical short circuit, more arterial blood will flow in the vein; this causes an increase in the size, thickness and blood flow in the vein. It then becomes easy to puncture this vessel for hemodialysis.

• ⦿ It is the joining of the blood vessels, under the skin. No tubes or needles are visible on the outside. It is usually performed in the non-dominant arm of the patient either at the wrist or elbow. Once the wound heals, only a thin, small scar of size 3 to 4 cm remains on the skin.

Your doctor will examine the hand vessels and may ask for Doppler study which accesses the vessel size and blood flow.

Yes. It is usually done under local (only the area of surgery will be numb) or regional (a large part of the limb will be numb) anesthesia. The effects of anesthesia are temporary and will last for a few hours. It takes around one hour to perform this surgery. Only in cases of difficulty, does it take longer. If the blood vessels for any reason are not suitable at the distal part of the forearm or at the wrist, other sites may also be selected, like the elbow, the upper forearm or the upper arm.