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Overview of hemodialysis arteriovenous fistula maintenance and thrombosis prevention

Michael Allon, MD
Section Editors
Jeffrey S Berns, MD
David L Cull, MD
Deputy Editors
Kathryn A Collins, MD, PhD, FACS
Alice M Sheridan, MD


This topic provides an overview of general issues regarding arteriovenous (AV) fistula maintenance, including measures to prevent AV fistula thrombosis and management of the high-risk fistula. These same considerations with respect to AV grafts are reviewed separately. (See "Overview of hemodialysis arteriovenous graft maintenance and thrombosis prevention".)


Many factors influence the choice of type and location for AV fistula creation and should be taken into account during patient selection and surgical creation of the fistula. Although some of these factors affect outcomes, once the access has been placed, they cannot generally be modified. (See "Overview of chronic hemodialysis vascular access" and "Risk factors for hemodialysis arteriovenous fistula failure".)

Other factors that can lead to AV fistula dysfunction and thrombosis include:

Pre-existing stenotic lesions

Cannulation injury/more frequent cannulation (ie, daily hemodialysis)

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Literature review current through: Sep 2017. | This topic last updated: Jun 16, 2017.
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