Top
40
Doctor insights on: Av Fistula Creation For Dialysis

Share
1

1
How do physicians de-clot an av fistula for dialysis patients?

How do physicians de-clot an av fistula for dialysis patients?

Open or endo: It can be done with tpa (alteplase) (a high-potency medication to dissolve blood clot) and a rotor-rooter device inserted through a needle stick in the access. I tend to make a small incision to remove the clot with a balloon catheter, then do an angioplasty on the area of stenosis (narrowing) which you usually find in the vein or graft. ...Read more

See 4 more doctor answers
Dr. Quresh Khairullah
520 doctors shared insights

Dialysis (Definition)

Simple answer is that it is a medical technology used primarily to provide an artificial replacement for lost kidney function in people with renal failure. Hemodialysis remove wastes and excess water from the blood by circulating blood outside the body through an external filter, called a dialyzer. Blood and dialysate flow through in opposite directions and the ...Read more


2

2
What does an av fistula for dialysis mean?

What does an av fistula for dialysis mean?

Arteriovenous fistul: It is an arteriovenous fistula. It is a surgical connection of an artery and a vein. Once "mature", it is where they insert the needles for the blood to flow to the dialysis machine. It can take 3 months or so from "creation" until it is ready to use. ...Read more

See 2 more doctor answers
3

3
Dialysis shunt and dialysis fistula the same?

Dialysis shunt and dialysis fistula the same?

No: A shunt, or graft, is a piece of synthetic tubular material inserted under the skin that dialysis needles insert directly into. A fistula is a connection of your own artery to a vein. Needles are then placed into the vein when the wall thickness matures. ...Read more

See 1 more doctor answer
4

4
What is the process of decloting an av fistula for dialysis patients?

What is the process of decloting an av fistula for dialysis patients?

Two methods : There are two methods: mechanical or chemical. Occasionally both methods are used. In general, the doctor accesses the av graft or fistula with a needle and places a tube into the graft. He then uses wires and catheters to cross the clot and inject clot busting meds. There are devices he can use that also break up clot. Or, he can open the graft and use special balloons to pull clot out. ...Read more

See 1 more doctor answer
5

5
Av fistula, av graft, subclavian or femoral catheter, av shunt permanent or temporary, which is better?

Av fistula, av graft, subclavian or femoral catheter, av shunt permanent or temporary, which is better?

AV fistula: Countless studies and decades of research have shown a clear advantage for patients who undergo hemodialysis through an av fistula. The second best is an av graft and all catheter-based modalities for hemodialysis are a distant third. ...Read more

7

7
What type of dialysis access procedure would be necessary for peritoneal dialysis?

What type of dialysis access procedure would be necessary for peritoneal dialysis?

PD cath: A peritoneal catheter is introduced in the lower abdomen to allow for introduction of fluids in and out. ...Read more

See 1 more doctor answer
8

8
Expert opinions? Which dialysis is better: peritoneal or hemodialysis?

Expert opinions? Which dialysis is better: peritoneal or hemodialysis?

To peritoneal or not: Hemodialysis cleans your blood directly meaning, your blood is taken from you, ran thru a filteration system, then returned to you. On the other hand, peritoneal does it indirectly. The blood vessels in your abdomen are exposed to a very concentrated solution. By osmosis, the concentrated solution will leech out the excess fluids you normally pee out if your kidneys were working well. As the ...Read more

See 1 more doctor answer
9

9
Cure of brain dural av fistula?

Cure of brain dural av fistula?

Not enough info: I am sorry; that question is so general that it is impossible to give you a satisfactory answer in the 400 characters we're allotted. Are you the one with the a-v fistula? Has it bled? What does your neurosurgeon say? ...Read more

10

10
Are av fistulas permanent?

Don't have to be: It takes a surgical procedure to connect the end if a vein to the side of an artery (create an av fistula). Once created, it will take another surgical procedure to shut the fistula down if need be. Most often they are kept in place even if not used as a back-up system for dialysis access. ...Read more

See 1 more doctor answer
11

11
What indication of hemodialysis peritoneal dialysis?

What indication of hemodialysis peritoneal dialysis?

Kidney failure: Hemodialysis and peritoneal dialysis are 2 effective types of treatment for kidney failure. Kidney function generally needs to be less than 10% before dialysis is needed. Kidney failure can be permanent or reversible. Kidney doctors (nephrologists) need to be involved in evaluation and treatment of kidney failure. There are 6 stages depending on severity. Stages 4-6 require specialist care. ...Read more

See 1 more doctor answer
12

12
With an av shunt for dialysis, will I still hear the bruit?

With an av shunt for dialysis, will I still hear the bruit?

No: The bruit is usually heard with a stethoscope by your physician. You may however feel the "thrill" of the fistula, which is similar to a cat purring. ...Read more

See 1 more doctor answer
13

13
What diet is appropriate for someone undergoing hemodialysis or peritoneal dialysis?

What diet is appropriate for someone undergoing hemodialysis or peritoneal dialysis?

Renal Diet: Patients who have ESRD (end-stage renal disease) and require dialysis need adequate nutrition (daily protein 1.2 gm/kg) but need to watch out for high phosphorus and potassium. Dialysis patients are assigned a dietitian to review their diet and to go over their blood test results to individualize their dietary needs. ...Read more

14

14
Can i restart peritoneal dialysis after having removed the catheter due to peritonitis, as i've blood clotting, deep vein issues with heamodialysis ?

Can i restart peritoneal dialysis after having removed the catheter due to peritonitis, as i've blood clotting, deep vein issues with heamodialysis ?

Difficult: After peritonitis, cavity will be obliterated, forms adhesions, loculations, will not allow free inflow and out flow, all the fluid will not return, also have to wait wks or months for pd , renal transplantation is best alternative, . ...Read more

See 1 more doctor answer
16

16
Diagonised with rectal cancer, after ileostomy reversal, frequent bm's, abcess withleakage at the surgery site. alternatives tocolostomy ?bowel trnspl

Diagonised with rectal cancer, after ileostomy reversal, frequent bm's, abcess withleakage at the surgery site. alternatives tocolostomy ?bowel trnspl

Insert drain: Ileostomy after rectal cancer is used to protect the rectal resuturing to establish continuity in the bowel. II there is some kind of abscess and leakage it can occur where the ileostomy has been reversed or at the site of the rectal suture line which may not have been ready for closure. Interventional radiology can place a suction drain to the site and left there until everything has healed. ...Read more

17

17
How effective is heart catheter surgery for atrial septal defect?

How effective is heart catheter surgery for atrial septal defect?

Good: If the defect is not overly large, and is located in the center part of the atrial septum (typically an osmium secundum atral septal defect), and there are no associated cardiovascular problems, the short-term and long-term outcomes are very good and catheter based closure is safe in experiences centers. ...Read more

18

18
For a dialysis, why is the subclavian catheter has darker blood rather than in patient with fistula?

For a dialysis, why is the subclavian catheter has darker blood rather than in patient with fistula?

Catheter vs fistula: An a-v fistula (avf) is a connection between an artery and a vein, that's why its called an a, for artery, v, for vein, fistula. Arterial blood has more oxygen, making it redder, than venous blood. A subclavian catheter has both blood tubes in the vein, where there is less oxygenated blood, as it does not have any arterial inflow. That's why it has darker blood than an avf. ...Read more

19

19
Per my medical records for an Ileostomy Reversal surgery I underwent, it states the surgeon did a Renal Autotransplant involving retroperitoneal fibrosis. Normal procedure? Explain, please.

Per my medical records for an Ileostomy Reversal surgery I underwent, it states the surgeon did a Renal Autotransplant involving retroperitoneal fibrosis. Normal procedure? Explain, please.

My take is ...: This question should be directed to the then surgical team. No one should make a "smart" comment or suggestion now after years from the surgery because how, when, and what should be done in individual procedures for medical calamities have changed and evolved over time. That is life. Let life and medicine evolve and move; it's unfair / un-smart to be a hind-sighted smart one. ...Read more

See 1 more doctor answer
21

21
What is the definition or description of: av fistula creation?

Artery to vein Conni: An av fistula is a direct connection made by a surgeon connecting a vein to an artery. These are usually performed in the wrist or elbow crease. These are created to increase blood flow in the vein so it can be used for dialysis access. ...Read more

See 2 more doctor answers
22

22
What is the process of decloting an av fistula for dialysis patients?

Two methods : There are two methods: mechanical or chemical. Occasionally both methods are used. In general, the doctor accesses the av graft or fistula with a needle and places a tube into the graft. He then uses wires and catheters to cross the clot and inject clot busting meds. There are devices he can use that also break up clot. Or, he can open the graft and use special balloons to pull clot out. ...Read more

See 1 more doctor answer
23

23
What is the purpose of a AV fistula for dialysis patients? I can't find anything good on the internet to explain this, please add link if you have one

High flow: An A-V fistula creates a peripheral region of high blood flow so that a large volume of blood can be removed and returned to the body for the "cleaning" done by the dialysis machine. ...Read more

24

24
What does an av fistula for dialysis mean?

Arteriovenous fistul: It is an arteriovenous fistula. It is a surgical connection of an artery and a vein. Once "mature", it is where they insert the needles for the blood to flow to the dialysis machine. It can take 3 months or so from "creation" until it is ready to use. ...Read more

See 2 more doctor answers
26

26
I am a dialysis patient for 2 yrs. I lift 5 to 10 pds of weights, is it okay for my av fistula. And what can I take to build muscle?

I am a dialysis patient for 2 yrs. I lift 5 to 10 pds of weights, is it okay for my av fistula. And what can I take to build muscle?

AVF and weights: The answer to your question about lifting weights being ok for your avf is "yes". You need to speak to your renal dietician about what you can eat to build up muscle. Good luck. ...Read more

27

27
How do physicians de-clot an av fistula for dialysis patients?

Open or endo: It can be done with tpa (alteplase) (a high-potency medication to dissolve blood clot) and a rotor-rooter device inserted through a needle stick in the access. I tend to make a small incision to remove the clot with a balloon catheter, then do an angioplasty on the area of stenosis (narrowing) which you usually find in the vein or graft. ...Read more

See 4 more doctor answers
29

29
Is an av fistula permanent or temporary?

Permanent w/o repair: An AV fistula, or arterial-venous fistula, is an abnormal connection between an artery & vein that allows high pressure arterial blood to travel into the low pressure venous system. It can be caused by traumatic blood vessel injury or purposely created surgically by a doctor (e.g for dialysis access). An AV fistula is always permanent unless repaired surgically or with covered stenting of vessels. ...Read more

See 2 more doctor answers
30

30
Is it true that av fistula is permanent?

Need info: A surgically created fistula for dialysis is not removed unless infected. An av fistula from other sources may need repair. Why do you have an av fistula? ...Read more

31

31
Can a person have an external av fistula?

Can a person have an external av fistula?

Yes- not practical: It turns out that the first "fistulas" made years ago when dialysis first started were "external" fistulas. They were actually synthetic/plastic tubes connecting an artery to a vein. There were significant problems with bleeding and infections. These "external" fist las are not used today. If someone needs urgent dialysis they get a catheter. For long term dialysis either a fistula or a graft. ...Read more

See 1 more doctor answer
33

33
Is it possible for a failed av fistula be reactivated?

Needssurgical eval: Clotting of the avf is the major problem facing patients on dialysis. Generally, it needs to be evaluated and declotted rapidly to be salvaged (within 1-2 days) by a vascular surgeon or interventional radiologist. The focus more recently is early prevention to prevent clotting from occuring through close monitoring of blood flows and pressures. ...Read more

34

34
What happens to your circulation when you have an av fistula?

Well, : An arteriovenous fistula is a disruption of the normal blood flow pattern. Normally, oxygenated blood flows to the tissue through arteries and capillaries. Following the release of oxygen in the tissues, the blood returns to the heart in veins. An arteriovenous fistula is an abnormal connection of an artery and a vein. The blood bypasses the capillaries and tissues, and returns to the heart. ...Read more

35

35
Cure of brain dural av fistula?

Not enough info: I am sorry; that question is so general that it is impossible to give you a satisfactory answer in the 400 characters we're allotted. Are you the one with the a-v fistula? Has it bled? What does your neurosurgeon say? ...Read more

36

36
What does it mean to have av fistula in left arm?

What does it mean to have av fistula in left arm?

Connect Vein&Artery: This is when a vein is surgically connected to an artery (end-to-side anastomosis). This maintains blood flow to the hand while diverting blood into the vein. The vein becomes pressurized to arterial pressure and had much higher blood flow. Over time its size will double and its walls thicken so that it can be accessed for dialysis. Left arm is most often used because it is the non-dominant arm. ...Read more

See 1 more doctor answer
37

37
What happens if you accidentally have taken blood pressure on av fistula?

Likely ok: the concern is for possible damage to the fistula leading to thrombosis or clotting of the system. If brief pressure from a one time inflation occurs then hopefully the risk of trauma is minimal and you will be ok. ...Read more

38

38
Please help! what happens to the radial pulse when you have an av fistula?

Normal: Av fistula creates an connection between artery and vein, however there is ongoing blood flow distally into radial artery.Radial artery pulsations will be normal after the avf. Surgeons will check the radial pulse after surgery, if there is decreased pulse, they will revise the fistula to ensure adequate blood flow in the fistula and radial artery. ...Read more

39

39
Why is my av fistula ugly?

Chronic use: Av fistulas tend to become dilated with use and time, and the access into the fistula should be rotated in different sites. The fistulas are close to the skin, and the majority are prominent, and there is no way to get around this. ...Read more

See 1 more doctor answer
40

40
How long for av fistula to mature?

Many factors: There are many things which effect avf maturation. Vein size, location, and type of fistula to name a few. In the best of circumstances, expect 6-8 weeks, but many times a fistula will take longer or need additional procedures to help it mature fully. ...Read more

Fistula (Definition)

A fistula is an abnormal connection between two places. Most commonly, it originates somewhere in the intestine and communicates to another location in the intestine or in the skin. A fistula can develop after abdominal surgery, with inflammatory bowel disease, cancer, anorectal abscess, and ...Read more


Dr. Sandip Kapur
18 doctors shared insights

Av Fistula Creation (Definition)

An av fistula is a direct connection made by a surgeon connecting a vein to an artery. These are usually performed in the wrist or elbow crease. These are created to increase blood flow in the vein so it can be ...Read more