Consent AVF

Surgical Complications and Risk Mitigation

Intra-Operative

Complication Description Potential Ways to Reduce Risk
Haemorrhage Damage to artery, vein or anastomosis leak requiring transfusion.
Injury to Surrounding Structures Depends on the specific location of the fistula.
Anaesthetic Risks Includes tooth/throat damage, drug reactions, nausea, cardiovascular/respiratory issues. Addressed in pre-op anaesthetist assessment.

Early

Complication Description Potential Ways to Reduce Risk
Pain Typically minimal pain post-operation.
Bleeding Minor bleeding and bruising at the fistula site.
Infection Rare superficial wound infections. Peri-operative antibiotics minimize infection risk.
Scarring Potential keloid scar formation.
Seroma Lymphatic fluid swelling due to node disruption. Careful lymphatic dissection and ligation.
Blood Clots Risk of DVTs/PEs post-op, especially in high-risk patients. Anti-embolism stockings and LMWH peri-op.
Failure to Mature About 20% of fistulas fail to form fully. Ensure optimal vessel diameters and meticulous technique.
Steal Syndrome Over-diversion of blood causing distal ischemia.
Stroke, MI, Kidney Failure, Death Low but possible risk in major surgery.

Late

Complication Description Potential Ways to Reduce Risk
Reintervention Fistulas may narrow, occlude, fail to mature, or develop steal syndrome requiring corrective treatment.