Causes, Symptoms, and Treatment of Arteriovenous (AV) Fistula

The cardiovascular specialists at UPMC Heart and Vascular Institute offer patients advanced treatment for arteriovenous (AV) fistula, an abnormal connection between an artery and a vein.

What is an arteriovenous fistula?

When blood flows through the body, it moves from your arteries to your capillaries to your veins. With an arteriovenous (AV) fistula, blood actually bypasses some of the capillaries and flows directly from an artery into a vein resulting in tissues below the bypassed capillaries receiving less blood.

How do I know if I have an AV fistula?

Small AV fistulas that occur in your legs, arms, lungs, kidneys or brain often occur without any symptoms and only need to be monitored by your doctor. Larger AV fistulas may cause:

• Swelling along with a reddish appearance on the skin surface
• Purplish, bulging veins that you can see through your skin, similar to varicose veins
• Swelling in the arms or legs
• Decreased blood pressure
• Fatigue
• Heart failure

An AV fistula in your lung is quite serious and can cause:

• Skin to look blue
• Finger clubbing
• Difficulty breathing (especially when exercising)
• Possible stroke

Causes of AV Fistulas

AV fistulas can develop anywhere in the body, but they typically occur in the legs. They can be caused from:

• Cardiac catheterization complications
• Injuries that pierce the skin
• Genetic conditions
• Congenital defects

Regardless of the cause, serious complications can develop if a large AV fistula is not treated, including heart failure, blood clots, leg pain, and stroke or bleeding.

How are AV fistulas diagnosed?

If you suspect you may have an AV fistula, your doctor will place a stethoscope over the area where a fistulas is suspected and listen for a sound similar to clicking or humming machinery (machinery murmur). If a murmur is heard, he or she will confirm it is caused by AV fistula, using one or more of the following diagnostic tests:

• Duplex ultrasound
• CT ultrasound
• Magnetic resonance angiography (MRA)

Treatment for AV Fistulas

For small fistulas that don’t cause any other health problems, you will simply need to be monitored by your doctor and see if it closes on its own. If you require treatment, your doctor may recommend:

• Ultrasound-guided compression – compresses the fistula and blocks blood flow to the damaged blood vessels. This procedure only takes about 10 minutes however it only works for about one in three people.
• Catheter embolization – insertion of a catheter in an artery near the site of your AV fistula using X-ray and other imaging techniques. A stent is placed at the site of your fistula to reroute blood flow.

Need more information?

Call UPMC Heart and Vascular Institute at: 717-231-8555

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Providers

• Daniel R. Calderon, MD
• David B. Loran, MD

UPMC Heart and Vascular Institute
Located at Brady Building
205 South Front Street
4th floor
Harrisburg, PA 17104
Phone: 717-231-8555
Fax: 717-231-8568