Vascular Access

Vascular Access

The aim of vascular access is to provide proper sites in order to draw out the blood. 


Hyderabad Vascular Center with Dr. Narendranadh Meda is providing the best vascular repair in Hyderabad in a most advanced and unmatchable manner using hybrid technique based approach.

About Vascular Access
Haemodialysis/dialysis is done when kidneys fail to function properly. A dialysis machine is an artificial/mechanical kidney that is used to filter out blood. In this, blood of the patient is made to pass through that dialysis machine, circulated in it and then returned back to the patient. Two needles are inserted into the patient’s bloodstream to carry out the procedure. It is required to be done at least three times per week. The aim of vascular access is to provide proper sites in order to draw out the blood. Arteriovenous fistula, arteriovenous graft, and venous catheter are three types of vascular accesses. The vascular accesses are usually created in the arm and sometimes in legs. We carry out these procedures in the most sophisticated manner and deliver the best vascular repair in Hyderabad.
Type Of Vascular Access
Arteriovenous Fistula

A surgeon creates a connection between an artery and a vein that is called as arteriovenous Fistula. The vein then undergoes enlargement and thickening and this process is called as maturation. A mature fistula makes repeated puncturing easy. It usually takes three to six months or can take up to a year in rare cases. Patients should undergo evaluation for arteriovenous fistula creation at least a year before the dialysis.

It is a preferred vascular access to lower rate of infection and clot formation, resulting in better success than other types of vascular access. But in some patients like elderly and ones with small veins, this procedure cannot be performed.

We are specialized for providing unmatchable AV access creation associated services and best vascular repair in Hyderabad.

Arteriovenous Graft

Patients who cannot go for arteriovenous fistula, an arteriovenous graft is considered for them. It is a piece of teflon or fabric made of artificial tubing which is attached on an artery at one end, and vein on the other end. The tube is placed entirely under the skin and is punctured during dialysis. It is used two to three weeks after the operation. However, infection and clotting is more with arteriovenous grafts than fistulas.

Venous Catheter

Venous catheter, a plastic tube, is inserted into a large vein. The outer portion of the catheter is exposed to the chest wall and allows the tubing for the dialysis machine connection. It is infection prone as the catheter is not entirely under the skin. Venous catheters may get clogged and lack efficiency in dialysis.

Venous catheters are mostly temporary vascular accesses, and are placed only when there is urgency to perform dialysis. Rarely, a venous catheter may be used for long-term vascular access when other options are unavailable.

How to Prepare For the Creation of Vascular Access?

The patient should reserve one arm for vascular access preparation; this arm shouldn’t be used for blood draws, IVs, or blood pressure checks. A venogram or a non-invasive duplex ultrasonography can be ordered by the vascular surgeon. A venogram is a unique x-ray technique. In order to acquire a detailed image of the veins, a contrast dye is injected into them during this procedure. Only patients with a history of many dialysis access operations or those whose venous anatomy is unknown need it. The patient will be advised about the necessary preparations and drugs by the vascular surgeon and his team.

Choose us for the best vascular repair in Hyderabad and top-rated vascular access-related services.

What to Expect During and After Operation?

Most vascular access procedures are done on an outpatient basis, under local anesthesia. The anesthesiologist administers certain sedative medication to allow the patient to stay relaxed and drowsy. Mostly General anesthesia is not used.

Patients should keep the incision covered and dry for at least two days, postoperatively. The incision should be avoided from soaking or scrubbing until the complete healing. The arm in which the incision was made, should be elevated with the help of a few pillows during sitting or sleeping. This will help minimize the swelling. A mild swelling and pain at the site of incision is acceptable postoperatively. The surgeon should be contacted as soon as possible if the symptoms become severe.

Patients might experience coolness, tingling or numbness in the fingertips of the arm where the access is created. It is very normal and improves or resolves with time. If these symptoms worsen, such a situation is called “steal”. In such a situation, contact your physician as soon as possible. This usually happens when the access which is created “steals” the blood away from the hand. This problem can be cured using certain procedures which restores the normal condition.

Potential Complications

Complications can occur due to contamination and bleeding. The health care professional must be contacted as quickly as feasible for any fever over 100 degrees Fahrenheit, discharge or bleeding from the incision. Stealing, as defined above, is an unusual hardship.

Non-maturation of arteriovenous fistulas is a potential complication. In different words, the vein never enlarges or turns thick-walled, which is sufficient for use for dialysis. In a few cases, reasons for non-maturation may be recognized and corrected, permitting maturation to arise. Our primary non-maturation rates are low as we scan (AFV mapping) all the patients planned for AV fistula creation before surgery to decide the site most optimal for AV fistula creation. 

After a fistula or graft has been in location for a length of time, it could turn out to be abnormally large or expand to form an aneurysm. A potential complication of aneurysmal degeneration could lead to rupture and bleeding from the fistula, which can be avoided by intervention at a timely manner. 

Arteriovenous fistulas and grafts can undergo narrowing (stenoses) due to repeated punctures 

for dialysis or at the anastomosis (connection site), which may also lower the performance of dialysis. Stenosis may be handled with an operation or with a minimally invasive/endovascular approach. (Link to minimally invasive and endovascular treatment options here.) Long segment clots of fistula are usually not amenable for salvage and patients may require new AV access options.

Tips To Keep the Access Healthy

The arm in which access is created should no longer be slept on or used to hold heavy items. The arm should no longer be used for blood withdrawal or blood pressure measurements and injections. Clothing or add-ons worn at the arm ought to be unfastened and non-constricting. The location over the access should be kept clean.

In the functioning, access vibration should be felt which is referred to as a “thrill.” The medical doctor or dialysis group of workers can display to the patient how the thrill is felt. If the affected person notices that the vibrations have disappeared, he/she ought to consult a medical doctor as quickly as possible.

So, seek the most sophisticated vascular services and the best vascular repair in Hyderabad at KIMS Hospitals.

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