What is AV Access?
When your kidneys stop functioning properly, dialysis becomes necessary to remove toxins and excess fluids from your body.
For dialysis to work, your blood must be safely removed, cleaned, and returned — multiple times a week.
But your regular veins are too thin and fragile to handle this.
To make dialysis safe and effective, doctors create a special surgical connection between an artery and a vein, usually in the arm. This is called an Arteriovenous (AV) Access — and it becomes your lifeline for dialysis.
When Should You Plan AV Access?
You should start planning your AV Access when:
- Your GFR drops below 15%
- Your nephrologist says dialysis is likely in the next 1–2 months
Early planning is key. It gives your AV access time to mature, and helps you avoid emergency catheter placement (which carries higher risk of infection and complications).
Who Creates AV Access?
AV Access is created by a Vascular and Endovascular Surgeon — a specialist trained to evaluate your veins and arteries using a Doppler ultrasound and perform the surgery safely.
The care team involved includes:
- Nephrologist → Refers you for AV access at the right time
- Vascular Surgeon → Evaluates and performs the procedure
- Dialysis Technician → Uses the access during each session
- Patient (You) → Monitors and protects the access daily
Why Can’t Normal Veins Be Used?
- Regular veins can’t handle high blood flow
- They collapse or clot easily
- They are not designed for repeated needle puncture
AV Access is designed to be stronger, deeper, and long-lasting. It supports blood flow of ≥300–400 ml/min, which is needed for effective dialysis.
Types of AV Access Used Globally
These are the most commonly used and surgeon-recommended options worldwide:
- Radio-Cephalic Fistula (RCF) – Created at the wrist
- Mid-Forearm RCF – Slightly higher than wrist, if veins are small
- Brachio-Cephalic Fistula (BCF) – Below Elbow
- Brachio-Cephalic Fistula (BCF) – Above Elbow
- BCF with Great Saphenous Vein (GSV)
- Brachiobasilic Transposition (BVT) – One-stage or Two-stage
- AV Graft (Synthetic Access) – Used when no natural vein is usable
- Radio-Cephalic Fistula (RCF) – Created at the wrist
Final Advice
“AV Access is not just a medical procedure — it’s your survival route on dialysis. It must be created with care, used with skill, and protected like a lifeline.”
Plan it early
Trust the right experts
Take care of it daily
A strong AV Access = Better Dialysis = Better Life
