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Comprehensive Care for Arteriovenous Fistula (AVF)

Expert Arteriovenous Fistula Care

Understanding all you can about your neurovascular condition helps you feel more confident and assured as you navigate treatment. At the AdventHealth Neuroscience Institute, we believe that expert care means more than state-of-the-art technology and world-renowned specialists. We believe you have a right to make informed decisions about your health care. 

When you ask questions, we’ll give you answers. Our role as compassionate caregivers is to help heal your body, but also your mind and spirit. 

Neurovascular conditions like arteriovenous fistula (AVF) aren’t always easy to understand. You’ll likely have fears and worries, but you can rest assured that your care team at the AdventHealth Neuroscience Institute will do all they can to keep you informed during every phase of your treatment, from the initial diagnosis through recovery. Because your peace of mind is as important to us as your physical health. 

About Arteriovenous Fistula

An arteriovenous fistula (AVF) is easier to understand if we break the name down into parts. “Arterio-” refers to your body’s arteries, and “-venous” refers to your body’s veins. 

In a healthy vascular system, arteries carry blood away from the heart and veins carry blood to the heart. This cycle of blood is how your body and all of its organs receive oxygen and nutrients. Arteries and veins don’t connect. Instead, tiny blood vessels called capillaries connect the veins and the arteries and help maintain normal blood flow. 

A fistula is two things that are abnormally joined. In the case of an AVF, a fistula is a place where an artery and a vein are abnormally joined without the capillary connectors. When blood is diverted in this way, it isn’t flowing through the body correctly. Certain parts of your body may not receive the oxygen and nutrients they need. 

The legs and arms are the most common places for AVFs to form, but they can also form in the lungs, liver, kidneys, head and neck. An AVF that forms within the brain or spinal cord is usually called an arteriovenous malformation (AVM) .

Sometimes, AV fistulas can be very small and may not produce any symptoms. If you have a larger AVF, symptoms might vary based on its location. 

Legs and Arms

If your AVF is in one of your legs or arms, you may experience visible signs of swelling. Bulging veins that resemble varicose veins may develop. You may also be at a higher risk of deep vein thrombosis.

Lungs

Symptoms of an AVF in the lungs include developing a blue tinge to the skin. You may cough up blood, too, if you have an AVF in your lungs.

Gastrointestinal Tract

A common symptom of an AVF in the gastrointestinal tract is blood in your stool. 

Risk of Heart Failure

An AV fistula becomes especially dangerous when it causes drops in blood pressure or prevents blood from reaching the heart. It can put you at an increased risk of developing blood clots or heart failure. If the muscles of the heart don’t receive the nutrients they need, the muscles weaken and can’t pump blood effectively. 

Like most health conditions, AVFs are more easily treated when they’re caught early. Be on the lookout for signs of an AVF if you:

  • Have high blood pressure
  • Have undergone a cardiac catheterization
  • Take blood thinners

Some people are born with an AV fistula. Other people may develop the condition from genetic diseases. Traumatic injuries that pierce the skin can also lead to the abnormal joining of arteries and veins. 

Cardiac Catheterization

Although rare, some people develop an arteriovenous fistula when they have a cardiac catheterization. This heart procedure uses a thin tube called a catheter to access the heart through blood vessels. In some instances, the catheter can damage the blood vessels and cause them to converge and widen. 

Dialysis Access Surgery

There are also instances when an AVF may be created on purpose. If someone requires hemodialysis (a procedure that purifies the blood) due to kidney failure, a doctor may surgically widen the blood vessels in the arm to make it easier and less painful to insert the dialysis needle. This procedure is called dialysis access surgery and is performed by a vascular surgeon.

The process of diagnosing an AV fistula in the arms or legs is relatively easy. Since these AVFs produce visible signs, your doctor can usually use a stethoscope to listen to the blood flow at the site of the enlarged vein or artery. The diagnosis can be confirmed with special imaging procedures that inject dye into the body, allowing the doctor to see if blood is bypassing the capillaries. 

Diagnosing an AVF that has no visible signs can be more difficult. It’s essential that you pay close attention to your body and let your doctor know if you notice anything out of the ordinary, such as unexplained bleeding, general fatigue or a sudden drop in blood pressure. Detecting an AVF early is the best way to prevent serious complications like heart failure or even stroke. 
 

If your AVF is small, it may not require treatment. Your doctor can monitor the site of the damaged blood vessels to ensure the condition doesn’t worsen. Larger AV fistulas or fistulas that are in high-risk locations such as the lungs or head may require more targeted treatment. 

Catheter Embolization

A catheter embolization, or endovascular embolization, is the most common AV fistula surgery. During this minimally invasive procedure, the doctor will use a catheter to access the fistula. Next, a blocking material such as a plug, glue or a tiny balloon will be threaded to the fistula and used to close the connection between the vein and artery. Most people can go home the day after embolization. 

Stent Microsurgery

Your doctor may recommend another type of AV fistula surgery if your fistula is very close to your brain, spine or major blood vessels. This surgery is similar to embolization, except that a tiny stent is used to block the flow of blood between the damaged vein and artery. 
 

Doctor with a patient.

Exceptional Results, Seamless Care Coordination

We’ll be with you every step of the way, from diagnosis to treatment and beyond. Contact us today to learn more about your care options for an arteriovenous fistula at the AdventHealth Neuroscience Institute with a care coordinator at your side.

Meet Your Care Coordinator