Chronic Kidney Disease - Vascular Access (arteriovenous fistula)

Chronic Kidney Disease - Vascular Access (arteriovenous fistula)

Patients with CKD who are starting or they are already on dialysis need some kind of access to be able to undergo dialysis.

This is achieved by creating an arteriovenous fistula, usually in the upper extremity. In a vein with sufficient flow and size is being used to perform hemodialysis.

After surgery, it takes about 8 weeks for the fistula to reach the appropriate size and can be used for hemodialysis (maturation).

In cases where the patient needs to undergo hemodialysis while waiting for the fistula to mature, non-permanent tunneled catheter is placed, through which hemodialysis takes place.

In some patients the veins are not suitable for the creation of the fistula. For this reason, special grafts are used to “connect” the vein to the artery.

These procedures do not require hospitalization and the patient is discharged home the same day.

Fistulogram/ Fistuloplasty of vascular access

It is quite common for these patients to have access dysfunction or limb swelling.

The most common causes are stenoses in the vein in the upper extremity, where the artery and vein connect, or more centrally in the chest.

The most common treatment is to perform, minimally invasively, angiography of the fistula, locate the blockages, and perform fistuloplasty with balloons to open the blocked sites.

The patient can undergo hemodialysis immediately after the operation.

Protect your vessels

Georgios Tzavellas, MD realizing the importance of vascular access in patients with chronic kidney disease, offers the entire spectrum of treatments, from the creation of the vascular access to the treatment of any malfunction.