Vascular Surgery
AV fistula is a vascular surgery done by a vascular surgeon to create a connection between an artery and a vein in patients with chronic kidney disease(CKD). This access is later used for dialysis .This is usually done in your elbow (Brachio cephalic) or wrist (radio cephalic) and sometimes central venous catheterisation.
This allows the vein to grow larger and thicker, becoming like an artery called Arterialisation of vein.
Dialysis is a process of removing excess fluids and waste from your blood when your kidneys are not functioning effectively that is when they have lost 80- 90 % of their function.
Dialysis helps to -
This assessment by a vascular surgeon before procedure will include:
Anesthesia-
Your surgeon discusses the options of anaesthesia based on patients status and may be any of the following -
After the need for AV fistula for Dialysis access has been clearly explained, the patient is taken up for surgery. Surgery is usually done under local anaethesia after which procedure is started after marking the arm and site of fistula creation. The vascular surgeon after careful dissection of artery and vein creates a communication between them by either side ti side or end to side anastamosis of the artery and vein.After the anastamosis the surgeon rechecks the patency of fistula and closes the wound. Post surgery, the surgeon gives clear instructions on the usage of the arm and exercises to keep it patent and functional.
The risks for AV fistula surgery include:
It’s possible to live 10 to 20 years on dialysis. The outlook varies depending on your age, overall health, the cause of kidney failure and other factors. If you get a kidney transplant, you can stop dialysis when your new kidney starts working.
Many people on dialysis continue to live active lives, working, raising families and traveling. When you travel, your healthcare provider can help arrange for you to get dialysis at a center at your new location. If you’re doing either type of self-dialysis, you can take dialysis solution bags and the portable home dialysis machine (if needed) with you.
People who use peritoneal dialysis may need to limit exercise or certain physical activities when the abdomen fills with dialysis solution. Otherwise, exercise is typically OK for people on dialysis. You should ask your provider about participating in specific activities or sports.
After surgery, it takes at least 1 month , although it takes 3-4 months for a fistula to mature enough for dialysis.
Avoid wearing anything tight over your AV fistula.
Avoid resting anything heavy on your AV fistula.
Do not allow blood to be drawn, blood pressure taken or intravenous lines to be placed in the arm that your AV fistula was made.
There is no restriction to most usual activity once the surgical site has healed.
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