AV Fistula Surgery in Ahmedabad
For kidney failure patients starting hemodialysis, establishing a reliable vascular access site is vital. An Arteriovenous (AV) Fistula is the gold standard access method, offering low infection rates and lasting durability. Dr. Apurva Agarwal performs microscopic anastomosis to create strong AV fistulas.
AV Fistula Key Facts
- Microvascular Connection: Anastomosis re-routes blood flow from an artery to a vein.
- Access Maturation: Vein walls thicken over 4-6 weeks to withstand dialysis needles.
- Low Clotting Risk: Better patency than plastic catheters or synthetic grafts.
The Creation & Maturation Cycle
Fistulas are typically created in the forearm (Radiocephalic) or upper arm (Brachiocephalic). Using surgical loops or a microscope, the artery is joined to the vein side-to-side or end-to-side. Since arterial pressure flows into the vein, the vein expands and grows strong.
We instruct patients on post-operative maturation exercises (like squeezing a soft rubber ball) to speed up vein enlargement. Pre-operative mapping via vascular mapping Doppler ensures the vessels are wide enough before making an incision.
Post-Op Care Guide
- Feel for the "thrill" (vibration) daily to verify the fistula is open.
- Avoid sleeping on the fistula arm or carrying heavy weights.
- Never measure blood pressure or draw blood from the fistula arm.