Diagnosis for AV Fistula
Before creating a vascular access (AV fistula) for dialysis, the vascular surgeon will ask your medical history to identify if you have any other underlying conditions. Preoperative diagnosis of the veins and arteries is also done. A thorough diagnosis of the arterial and venous system is necessary, especially for the patients who have grade 4 or 5 Chronic Kidney Disease (CKD) or other conditions like diabetes, peripheral vascular disease, etc.
Various imaging tests, such as doppler ultrasound, CT angiogram, MRA (magnetic resonance angiogram), modified Allen test, and other tests are also done to examine the axillary, brachial, radial, and ulnar pulses in both upper extremities.
An Ultrasound or angiogram is used to determine the size and depth of the arteries and the veins to decide whether or not the blood vessels can support the AV fistula.
The whole analysis is also known as vessel mapping. The results of the diagnostic procedures will help to determine whether AV fistula surgery is the safest option for dialysis access or not.
AV Fistula Surgery for Dialysis
Before creating a vascular access (AV fistula) for dialysis, the vascular surgeon will ask your medical history to identify if you have any other underlying conditions. Preoperative diagnosis of the veins and arteries is also done. A thorough diagnosis of the arterial and venous system is necessary, especially for the patients who have grade 4 or 5 Chronic Kidney Disease (CKD) or other conditions like diabetes, peripheral vascular disease, etc.
Various imaging tests, such as doppler ultrasound, CT angiogram, MRA (magnetic resonance angiogram), modified Allen test, and other tests are also done to examine the axillary, brachial, radial, and ulnar pulses in both upper extremities.
An Ultrasound or angiogram is used to determine the size and depth of the arteries and the veins to decide whether or not the blood vessels can support the AV fistula.
The whole analysis is also known as vessel mapping. The results of the diagnostic procedures will help to determine whether AV fistula surgery is the safest option for dialysis access or not.
AV fistula surgery for dialysis, also known as Vascular Access Surgery, is usually performed through minimally invasive techniques. The doctor will administer local anesthesia in the access site and the following steps will be carried out-
- A small incision will be made in the surgical site to gain access to the arteries and veins. Generally, the non-dominant arm is chosen for the procedure, also known as the access arm.
- The artery (that carries blood from the heart) and vein (that carries blood back to the heart) are joined together to make a small channel, i.e., fistula.
- Once the AV fistula for dialysis is created, the cut is closed with the help of dissolvable stitches.
The surgery is performed on an outpatient basis and takes around an hour to complete. The patient is discharged on the same day and the surgeon will give you specific instructions that will help you to take care of the access arm.