AV fistula

Definition: What is an AV fistula?

The term “AV fistula” is an abbreviation for the term arteriovenous fistula. It refers to a direct short circuit connection between an artery and a vein. Normal blood flow takes place from the heart through the arteries to the smallest blood vessels at the individual organs and from there through the veins back to the heart.

An AV fistula leads to a direct blood flow from the artery into the vein via a connection. Most AV fistulas are artificially produced, for example for dialysis treatment. In addition, there are pathological AV fistulas, which are usually the result of an injury to a blood vessel, for example during a cardiac catheter examination.

AV fistulas can also be congenital. Possible locations are the groin region, the brain or the spinal cord. Since the pathological AV fistula leads to a disturbance of the normal blood flow, it may have to be surgically removed.

Therapy of AV fistulas

The treatment of an AV fistula depends, on the one hand, on where in the body it is located and, on the other hand, whether and to what extent it causes discomfort or stress for the patient. Smaller superficial arteriovenous fistulas can often be treated with a pressure bandage. This is intended to ensure that the vessel connection closes again spontaneously.

However, surgical or interventional therapy is often required to treat an AV fistula. If the fistula is located in the brain, for example, a small platinum spiral can be inserted into the fistula through a catheter advanced into the blood vessels. This ensures that the vascular connection closes.

Such a procedure is called embolization. Another method of achieving embolisation of an AV fistula is the injection of certain substances. This is also done by means of a specifically advanced vascular catheter.

If embolization is not possible or if there are reasons against such a procedure, the treatment of an AV fistula can only be achieved by vascular surgery. In this procedure, the vascular connections are usually loosened using a scalpel or laser beam, and the blood vessels are blocked or closed. Depending on where the AV fistula is located, how large it is and how much blood flows through it, this can be a minor intervention or a complex operation.

The prognosis for an AV fistula is as follows

The prognosis in the presence of an AV fistula depends mainly on the patient’s general condition and concomitant diseases. If a fistula requiring treatment is diagnosed and treated in time, the prognosis is often good. However, the prognosis for therapy depends to a large extent on the organ or body region in which the AV fistula is located.

The prognosis for an artificial AV fistula, for example for dialysis, is often limited due to the kidney dysfunction and the fact that other organs are often simultaneously restricted compared to healthy people. Nevertheless, many people can live with an AV fistula for many years even if they have to undergo dialysis. In some cases, a kidney transplant can even eliminate the need for dialysis, so the prognosis can be very good.