Minimally Invasive Arteriovenous Fistula Creation
The Arteriovenous fistula is created by attaching an artery to a vein under ultrasound guidance. Until now this could only be done through a surgical procedure. The Ellipsys® EndoAVF replaces surgery with a needle puncture in the vein below the elbow. This is a smaller incision that does not require sutures.
The arteriovenous fistula is the preferred access for hemodialysis. This access is the safest and least costly access for hemodialysis when compared with catheter dialysis and arteriovenous grafts.
How Should I Prepare?
Prior to the procedure, you will have on office visit with history, physical exam, and ultrasound of your arm. Bring all of your medicines or a complete list of your current medications including dose and frequency to the office visit. If you are not currently taking an anti-platelet medication (like Aspirin) you may be started on one prior to your procedure.
On the day of your procedure arrange for transportation to and from your procedure. You will be sedated and/or have a nerve block during the procedure and are unable to drive.
Upon arriving at Richmond Vascular Center, you will be brought to your pre-procedure room where you can change your shirt for a gown. There is a locker in your room for your clothes. Our nurse will get you ready for your procedure by starting an IV. If you are getting a nerve block it will be done here.
The procedure is performed in an operating room with special ultrasound and X-ray equipment. You will lay on your back with your arm out to your side. Your arm will be sterilely scrubbed with antiseptic solution and draped for the procedure. Your skin will be numb from a nerve block or local anesthetic (numbing medication) will be administered. A vein at the elbow will be entered (like for drawing blood) and the procedure will be performed through this single venous access. There may be mild discomfort during the procedure. The procedure will take approximately 30 minutes. Once the procedure is completed pressure will be placed at the venous access site to stop any bleeding and a small bandage will be placed. You will return to your pre-procedure room for 60 to 90 minutes of recovery. Written instructions will be provided to you at discharge.
- Relax–don’t do anything stressful.
- You may eat and drink as usual.
- For 24 hours: don’t drive or use heavy machinery, don’t make any legal or financial decisions, don’t sign any important papers, don’t drink alcohol, and don’t lift anything any heavier than a 2-liter bottle of soda, don’t wear clothing that will press against your wound.After 24 hours post-procedure you can return to usual activities.
- If you received a nerve block for your procedure please see special nerve block discharge instructions.
Will I feel any pain?
You may have some mild pain, swelling, and bruising at your puncture site. This is normal.
Will I have stitches? If so, when will they be removed?
You will not have any internal or external stitches. You will have a small bandage covering your needle puncture site.
What should I watch for post-procedure?
- Any worsening redness or swelling around the puncture site
- Warmth around the puncture site
- Pus issuing from the puncture site
- Lack of pulse or weak pulse at the puncture site