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Vascular Surgery

AV FISTULA

Vascular Surgery

Best Center for AV fistula treatment in Kphb | Kukatpally | Hyderabad

My health hospitals has best vascular surgeons with 10 + years of experience in the field of in treatment of various vascular problems and their treatment with best and advanced technology with best results through safe and painless surgery with less hospital stay duration and prevent future problems and recurrence .

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Dr. Puneeth Joopalli
Dr. Puneeth Joopalli
MBBS, DNB
(Fellowship in Minimal Access Surgery)
Vascular and Endovascular Surgeon
Timings : 10 am - 6 pm
4.8 : myhealthhospital
based on 920 reviews
---- DIALYSIS ----

AV Fistula – Dialysis

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 -

  • control your blood pressure
  • Keep electrolyte balance in the body
  • Remove excess waste, salt, and water to prevent them from building up in your body

WHAT ARE THE PRE REQUISITES BEFORE SURGERY ?

This assessment by a vascular surgeon before procedure will include:

  • A detailed explanation of the procedure , its benefits , risks and follow up
  • a physical exam of the arm for veins where surgery needs to be done
  • An ultrasound of the arm to now venous calibre

Anesthesia-

Your surgeon discusses the options of anaesthesia based on patients status and may be any of the following -

  • Local anesthetic: Most commonly used anaesthesia
  • Regional block: Anaethesia for the entire arm.
  • General anesthetic – Only in selected cases based on the patients condition
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HOW IS THE AV FISTULA DONE ?

What should you expect after AV fistula surgery?

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.

POST OPERATIVE INSTRUCTIONS Include –
  • Keep the wound clean
  • Exercising your surgery hand daily by using a squeeze ball
  • Wash the area before each dialysis session.
  • No Intravenous medications through the operated arm
  • Donot lift heavy weights with the operated arm.
  • Donot wear tight clothing over arms
  • Donot sleep on the operated arm or put any kind of pressure on the arm.
  • Donot draw blood from that arm and donot check blood pressure on that arm
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What are the risks of AV fistula surgery?

The risks for AV fistula surgery include:

  • Clotting – noted in some cases
  • Steal syndrome- Rare
  • Numbness in the thumb – Secondary to any nerve compression.
  • Infection – can happen with any surgery if wound care is not proper after surgery
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---- FAQs ----

AV Fistula

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.

  • Remains functional longer than other forms of vascular access
  • No synthetic material implanted in your body
  • Provides the necessary blood flow needed for effective dialysis, which may help to decrease treatment time
  • Low risk of infection
  • Less prone to clotting than other dialysis access options
  • Created in an outpatient procedure under local anesthesia
  • Fast return to your daily activities

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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