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Fistula Thrill

Last week my wife had an operation to put a fistula in her left arm, just above the elbow. The surgeon checked it while she was in recovery and claimed it was successful. However, now, a week later, we cannot feel the "thrill" or hear, with the aid of a stethoscope, the whooshing sound we were told to check for. Neither could the nurse who removed the dressing yesterday, and she suggested a further scan to check its function. It may be due to swelling following the trauma of the operation but, should we be worried that the fistula is not working and what happens next?

7 Replies

You should see an access nurse (fistula nurse) who will usually request the scan.

I would check out the fistula care tips, and exercise the fistula arm several times a day to ensure it strengthens.



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Thank you. The nurse who removed the dressing said she would organise a scan. Exercising the arm is not easy as it is so painful still.


You should still exercise as much as you can. A stress ball is good, and lifting and lowering your arm if you can.

If there's NO thrill/or buzz at all you MUST get to the hospital and have it checked ASAP..


Hi, I recently had a fistula prepared- 4.5 weeks ago. After a week I saw my specialist nurse to have the dressing changed, then after that changed it myself every morning.

Had to see my nurse again after a week as the wound was leaking a little. Met with my nurse after two weeks and all seemed to be progressing ok. Following week (week3) nurse scanned the fistula and formation progressing and I could feel the "bruit" the vibration caused by the fistula formation, a strange feeling. Week 4 met with nurse for a scan again and measure the vein size again, 6mm so really good but the lamina blood flow is showing a turbulence which indicates a restriction in part of the vein.

I will now have a fistulagram, a procedure to enlarge the small restriction, a tube will be inserted along the vein and a ballon used to enlarge the vein, if this does does not work a stent will be inserted. meet with my nurse again this Friday for a scan to check, it may be ok, we will see. After 6 weeks I will meet with my renal vascular surgeon who will carry out a dollar scan to check the blood flow and if all ok start my heamo training ready for home heamo.

All sounds pretty horrific but my heamo team are so good at explaining what is happening at every stage along this journey.

Talk with your team and ask questions and I am sure you will feel better informed about the process.

My pd and heamo team have been and continue to be so helpful and supportive.

Best wishes-Philip


Many thanks. We are awaiting an appointment for a scan and due to see our renal consultant Monday afternoon. Hopefully then, all will become clearer.


Hi. After my first visit the nurse provided me with a tourniquet and a squeeze ball " a model house provided by nextstage. I apply the tourniquet and squeeze the "house" for 4-5 minutes 3-4 times a day. Hope all goes well with your consultant -Philip


My wife saw her consultant who more or less confirmed that the fistula had failed. She has to have a scan on the 31st. The consultant said they could not do anything with the failed arm so she would have to have another one in her other arm. My concern is, if that one also fails, where do they go next?


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