Arteriovenous fistula AVF

What is the arteriovenous fistula for haemodialysis?

An arteriovenous fistula (AVF) is a surgical connection between an artery and a vein, usually in the arm, that is created to provide access for hemodialysis.

During hemodialysis, blood is removed from the body and filtered through a machine that removes waste products and excess fluids before returning the clean blood back into the body. In order to access the blood vessels, a hemodialysis needle is inserted into the AVF, which allows for blood to be drawn from the patient and returned after being filtered by the dialysis machine.

AVF is the preferred method for hemodialysis access because it provides a durable and reliable connection that can withstand the repeated punctures required for hemodialysis. The AVF allows for a larger volume of blood flow, which results in more efficient hemodialysis treatment and lower risk of complications such as infection or clotting. The creation of an AVF usually requires a minor surgical procedure, and it may take several weeks or months for the fistula to fully mature before it can be used for hemodialysis.

What is the price for an arteriovenous fistula?

The cost of an arteriovenous fistula (AVF) can vary depending on various factors such as the country or region where the procedure is performed, the healthcare provider, and the patient’s insurance coverage.

In Tunisia, the cost of an AVF creation surgery can range from $1,500 to $3,000 or more, depending on the location and the individual provider. However, it is important to note that many insurance plans cover the cost of AVF creation surgery for patients with end-stage renal disease who require hemodialysis.

What you need to know before the procedure?

Before undergoing an arteriovenous fistula (AVF) creation surgery, it is important to have a thorough understanding of the procedure, its risks and benefits, and the recovery process.

Here are some important things to consider :

• Pre-operative evaluation : You will undergo a series of tests and evaluations to ensure that you are a suitable candidate for the surgery. These may include blood tests, imaging studies, and vascular access mapping ;
• Risks and benefits : Your healthcare provider will discuss the potential risks and benefits of the procedure with you. This includes potential complications such as bleeding, infection, and nerve damage ;
• Medications : Inform your healthcare provider of any medications you are taking, including over-the-counter medications, supplements, and herbal remedies. Some medications may need to be stopped prior to the surgery ;
• Fasting : You may need to fast for several hours before the surgery, depending on the type of anesthesia that will be used ;
• Anesthesia : You will receive anesthesia during the procedure to numb the area and prevent pain. Your healthcare provider will discuss the type of anesthesia that will be used and any associated risks ;
• Recovery : After the surgery, you will need to rest and limit the use of the arm where the AVF was created. Your healthcare provider will provide instructions on caring for the surgical site, as well as any medications you may need to take ;

It is important to communicate openly and honestly with your healthcare provider about any concerns or questions you may have about the procedure. By being well-informed and prepared, you can help ensure a successful outcome and a smoother recovery.

During procedure

During an arteriovenous fistula (AVF) creation surgery, the following steps typically occur :

• Anesthesia : Before the procedure begins, you will receive anesthesia to numb the area where the surgery will take place. Depending on the specific procedure and your medical condition, you may receive either local anesthesia or general anesthesia ;
• Incision : Your healthcare provider will make an incision in the skin over the artery and vein where the AVF will be created ;
• Artery and vein connection : Your healthcare provider will connect the artery and vein using a surgical technique called an anastomosis. This allows blood to flow from the artery to the vein, creating the AVF ;
• Closure : Once the AVF has been created, your healthcare provider will close the incision with stitches or surgical glue ;
• Post-operative care : After the procedure is complete, you will be monitored in a recovery area to ensure that you are stable and awake. You may be given pain medication or antibiotics to prevent infection, and you will receive instructions on how to care for the surgical site at home ;

The procedure typically takes between 1-2 hours, but this may vary depending on the individual case. Your healthcare provider will be able to provide more specific information about what to expect during the procedure based on your individual needs and medical condition.

The result of the operation

The result of an arteriovenous fistula (AVF) creation surgery is a surgically created connection between an artery and a vein that allows for hemodialysis treatment to be performed.

After the surgery, it may take several weeks or even a few months for the AVF to mature and become fully functional. During this time, your healthcare provider may monitor the AVF to ensure that it is healing properly and that blood flow is developing as expected. Once the AVF has matured, it can be used for hemodialysis treatment.

A successful AVF creation surgery can provide long-lasting, reliable vascular access for hemodialysis. However, it is important to note that there are risks associated with any surgical procedure, and there is a risk that the AVF may not work as intended or may develop complications over time. Some potential complications of AVF surgery may include infection, bleeding, clotting, or nerve damage.

Overall, the success of an AVF creation surgery depends on a variety of factors, including the patient’s individual medical condition, the experience and skill of the healthcare provider performing the surgery, and the patient’s adherence to post-operative care instructions. Your healthcare provider can provide more information on what to expect in terms of outcomes and potential complications based on your individual case.