Medical expert of the article
New publications
Arteriovenous fistula: causes, symptoms, diagnosis, treatment
Last reviewed: 05.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
[ Symptoms of arteriovenous fistula
A fistula may cause symptoms of arterial insufficiency (eg, limb ulceration due to decreased arterial flow, embolism, or ischemia) or chronic venous insufficiency due to the effects of high arterial flow pressures on the injured veins (eg, peripheral edema, varicose veins, congestive pigmentation). If the fistula is superficial and palpable, the injured area is usually swollen and warmer than the rest of the skin, with distention and often pulsation of the superficial veins. A thrill may be palpated over the fistula, and auscultation may reveal a continuous purring murmur that increases in intensity during systole. Occasionally, high-output heart failure develops if a significant portion of the cardiac output is shunted through the fistula to the right side of the heart.
How to examine?
Treatment of arteriovenous fistula
Congenital fistulas are not considered an indication for treatment unless serious complications develop (eg, lengthening of one leg in a growing child). If necessary, percutaneous endovascular treatments can be used with placement of occlusive structures to close the fistula. Treatment is rarely completely satisfactory, but complications can be controlled. Acquired fistulas usually have a single major connection, in which case surgical treatment is effective.