Arteriovenous Fistula (AVF)

An arteriovenous fistula (AVF) is an abnormal connection between an artery and a vein. “Arteriovenous” refers to the arteries and veins. The term “fistula” is used when two things are connected that shouldn’t be.

Arteriovenous fistula is most often a condition caused by injury or trauma. They can be found in multiple locations and commonly found in the head, neck, or spine.

Understanding an AVF

Your arteries carry oxygen-rich blood throughout your body. Then the veins bring oxygen-depleted blood back to your heart and lungs. Arteries carry fast, high-pressure blood flow. Veins are typically under lower pressure.

Normally, your arteries and veins are connected by tiny vessels called capillaries. The capillaries slow down the blood flow and help supply nutrients from the blood to the surrounding tissue.

An AVF bypasses the capillaries. The blood travels directly from high pressure area in your arteries to the low pressure area in your veins. This abnormal connection can cause your veins to swell or bleed. And, without the capillaries, the tissue around your fistula may not get the essential nutrients they need.

Problems with blood flow, pressure and nutrient deprivation can cause tissue death around the fistula. In some cases, an AVF can be life-threatening or disabling.

Signs and symptoms of and AVF are very similar to arteriovenous malformation and also include pulsatile tinnitus or hearing a constant whooshing sound in one ear. A spinal AVF would cause symptoms including lower extremity weakness, paralysis lack of coordination or back pain.

AVF Treatment Options

With treatment, the goal is to close off the AVF before the abnormal blood flow can cause brain or spinal cord damage.

An AV fistula is typically treated with one of two surgical approaches: endovascular embolization or surgery. Our team will meet and consult on the best strategy for you. Our team includes experts in all our treatment approaches, so we can recommend the safest, most effective treatment for you.

  • Endovascular embolization is a common treatment for AVFs. During this procedure, we guide a catheter through an artery to the location of your fistula. Once there, we inject a glue-like substance or insert small metal coils into the spot where the artery and vein meet. This stops the abnormal blood flow. After we close the connection, the AVF will usually not reoccur.
  • Surgery may be necessary when the AVF is large or in an area that can’t be treated with endovascular embolization. The type of surgery (microsurgery, open surgery), depends on the nature of your AVF.

In some cases, the procedures above may be used in combination. It’s also possible that your doctor may recommend ongoing observation, instead of treatment. This may be the appropriate choice if your fistula is small and isn’t causing other health problems. Some small AVFs will even close themselves without treatment.

Hope for Patients with AVFs

If you or someone you care about has an AVF, consult the specialists at Aurora BayCare. We are continually pioneering new treatment, diagnosis, and prevention approaches for cerebrovascular diseases and disorders.

Our dedicated team of neurosurgeons and other expert clinicians are here to help you understand your options and provide a clear path forward. In our experience, most AVFs can be successfully treated, and patients have a good prognosis.

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