When blood flows through your body, it moves from your arteries to your capillaries to your veins. With an arteriovenous (AV) fistula, blood bypasses some of the capillaries and flows directly from an artery into a vein. This causes tissues below the bypassed capillaries to receive less blood.
Small AV fistulas often don’t have symptoms, but large AV fistulas can be dangerous and require treatment.
The vascular surgery specialists at UPMC offer advanced treatment for AV fistula.
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An AV fistula is an abnormal connection between an artery and a vein.
When blood flows through the body, it moves from your arteries to your capillaries to your veins. With an AV fistula, blood bypasses some of the capillaries and flows directly from an artery into a vein. This causes the tissues below the bypassed capillaries to receive less blood.
The most common AV fistulas are deliberately created for people who need dialysis. The least common are those present at birth.
AV fistulas can occur anywhere in the body but typically occur in the legs. Other common locations include the arms, lungs, kidneys, or brain.
A vascular surgeon creates an AV fistula to help people more easily connect to a dialysis machine for treatment. An AV fistula creates an access point where needles from the dialysis machine can be inserted into the blood vessels.
An AV fistula can be caused by:
You may be at higher risk for AV fistula if you:
Serious complications can develop if a large AV fistula is not treated, including heart failure, blood clots, leg pain, stroke, or bleeding.
The pressure of blood flowing from the artery directly into the vein causes the vein to enlarge, giving it a bulging, purplish appearance.
Small AV fistulas that occur in your legs, arms, lungs, kidneys, or brain often occur without any symptoms and only need to be monitored by your doctor. Larger AV fistulas may cause:
An AV fistula in your lung can cause serious symptoms, including:
If you have an AV fistula, you should contact your doctor immediately. If you have severe symptoms, go to the nearest hospital emergency room or dial 911.
Your doctor may be able to diagnose an AV fistula during a physical exam. You may need other tests to confirm the diagnosis.
During your physical exam, your doctor will:
Your doctor will place a stethoscope over the area where the fistula is suspected and listen for a sound similar to clicking or humming machinery (machinery murmur). If your doctor suspects you may have an AV fistula, they may order additional tests.
Your doctor will confirm your murmur is caused by AV fistula using one or more diagnostic tests, including:
Some small AV fistulas may not require immediate treatment. However, large AV fistulas can cause serious symptoms if left untreated. Your doctor will recommend the best treatment for you based on the size and location of your fistula, as well as your symptoms.
At UPMC, our experts offer advanced treatment for AV fistula. Your doctor will recommend the best treatment option for you, which may include:
For small AV fistulas that don’t cause any other health problems, you will need to be monitored by your doctor. Your doctor may recommend routine follow-up visits to see if the fistula closes on its own.
This 10-minute nonsurgical procedure compresses the fistula under ultrasound guidance and blocks blood flow to the damaged blood vessels. Although it is noninvasive, it only works for about one in three people.
During a catheter embolization, your doctor will insert a catheter into a blood vessel and use x-ray or other imaging techniques to guide it to the site of your AV fistula. After the catheter is in place, your doctor will close the abnormal connection.
In some cases, your doctor may insert a small tube called a stent at the site of your fistula to reroute blood flow.
AV fistula treatment is effective for managing symptoms and preventing complications.
When you choose UPMC for AV fistula care, you will benefit from:
Last reviewed by a UPMC medical professional on 2024-10-01.
