In case of terminal renal insufficiency, the filtering function of the kidneys has to be replaced by dialysis. The principle consists of cleansing the blood with a haemodialysis machine.
It is therefore a matter of creating a vascular access to withdraw blood, filter it, and then reinject it in the organism at a sufficient flowrate.
There are several approaches to haemodialysis: central catheter, arteriovenous fistula or, in rare cases, a prosthesis. The native fistula will be preferred for its minimally invasive nature, ease of use and low risk of infection.
An arterial and venous Doppler ultrasound has to be carried in the consultation room to determine the optimal site for creating the arterio-venous fistula.
The surgery is performed under loco-regional anaesthesia to obtain a vasodilation of the target vessels.