Pros & Cons of Fistula

Pros

• The AVF is the "gold standard" for hemodialysis access
• It lasts longest and has the fewest problems, including
infection.

Cons
• The main disadvantage of an AVF is how long it can take to mature: 4-6 weeks or more.
• Some fistula also fail to mature at all, a problem called early or primary failure.
• A fistula may not mature if:
     • The anastomosis is too small, so less blood flows into the fistula
     • A stenosis develops at the inflow between the anastomosis and the fistula
     • Side veins off of the AW (accessory veins) reduce pressure in the fistula, so it does not arterialize.
     • The vessel chosen by the surgeon was too small (<2 mm)

Pros & Cons of Fistula - Related Hemodialysis Article