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Dialysis Access Surgery in Bhubaneswar

Dialysis Access

Dialysis Access Surgery in Bhubaneswar

The Radiology Department at Manipal Hospitals in Bhubaneswar, Odisha, offers specialised services for dialysis access. Dialysis access procedures are critical for patients with kidney failure who require regular dialysis treatments. These procedures involve creating and maintaining access points in the body, such as arteriovenous (AV) fistulas, grafts, or central venous catheters, to ensure efficient and reliable dialysis sessions.

Our skilled interventional radiologists utilise advanced imaging techniques to guide these procedures, ensuring precision and minimising complications. We are committed to providing high-quality, patient-centered care to improve the quality of life for those undergoing dialysis. We prioritise your health and well-being, offering comprehensive support and expertise in managing dialysis access needs.

FAQ's

When the kidney fails, dialysis—either hemodialysis or peritoneal dialysis—replaces kidney function and can save lives. Dialysis requires a connection between the patient's bloodstream and the dialysis machine for treatment to take place. To introduce an abdominal catheter for peritoneal dialysis or a needle for hemodialysis, a vascular opening is created during dialysis access surgery. Dialysis access can be established in a few different ways. Together, your surgeon and nephrologist (a doctor who treats kidney disease) will determine which kind of access will give you the greatest long-term dialysis.

There are three main types of dialysis access:

  • Arteriovenous Fistula (AVF): This is the preferred type of access for long-term hemodialysis. It involves surgically connecting an artery to a nearby vein, typically in the arm. Over time, the vein becomes larger and stronger, providing a reliable access point for dialysis.

  • Arteriovenous Graft (AVG): If an AVF cannot be created due to inadequate veins, an AVG may be used. This involves surgically implanting a synthetic tube (graft) to connect an artery to a vein, providing an alternative access point for dialysis.

  • Central Venous Catheter (CVC): In some cases, a CVC may be used for temporary or immediate dialysis access. A catheter is inserted into a large vein in the neck, chest, or groyne, allowing for immediate access to the bloodstream. However, CVCs are associated with a higher risk of infection and complications compared to AVFs or AVGs.

The choice of dialysis access procedure depends on factors such as the patient's vascular health, the availability of suitable veins, and the anticipated duration of dialysis treatment.

There are two types of catheters: temporary and permanent.

  • Temporary catheters go straight through the skin and into the veins. Permanent catheters likewise pierce the skin, but they pass through many inches of subcutaneous tissue before entering the venous system. Infection risk is decreased when the catheter is tunnelled. For slight discomfort, any medical expert can administer a local anaesthetic and minimal sedation to insert a temporary catheter.

  • The catheter used for hemodialysis is a tunnelled catheter because it is inserted beneath the skin. There are two types of tunnelled catheters: cuffed and uncuffed. Non-cuffed tunnelled catheters are used in emergencies or for brief periods (up to three weeks). A tunnel will be created just beneath the skin between the two incisions. The flexible dialysis catheter is then transferred from the second incision via the tunnel to the first incision. This is where it is passed over the guidewire to its final place.

Nonetheless, a surgeon in the operating room or an interventional radiologist in the interventional suite is required for the implantation of permanent catheters. Fluoroscopy, or continuous X-rays, is a tool used by doctors during procedures to ensure proper catheter placement. Temporary catheters can be easily removed, however permanent catheters need a small operation.

An AV fistula can be made in your:

  • Upper arm
  • Inner elbow
  • Wrist
  • Forearm

When created correctly and matures to a desirable degree, an AV fistula can last for many years.

For your access site to continue operating properly, it will require some ongoing maintenance. For as long as you have access to this, take note of the following safety measures: 

  • Never allow someone to insert an IV or take blood from your access arm. 

  • Find out from your physician or nurse how to get a medical alert bracelet. This alerts medical staff to avoid using that arm for blood draws or IVs.

  • Never allow your access arm to be used to take your blood pressure. 

  • Nothing restricting should be worn on your access arm, such as a watch, tight sleeve, or other jewellery. 

  • Never use your access arm to support a briefcase or purse. Refrain from dozing off on your access arm. 

  • Maintain the dressing's dryness and cleanliness of access. If it gets dirty or wet, change the dressing.

All three forms of vascular access have some dangers, just like any other kind of treatment. Among them are the following: 

  • Virus infection
  • Blood clots
  • Low blood pressure 
  • Aneurysm (a bulge in the blood vessel wall)
  • Carpal tunnel syndrome 
  • Bleeding
  • Increased venous pressure
  • Arterial insufficiency

Inserting any form of catheter can be painful; thus, anaesthetic gel may be applied to the region to alleviate pain. You may also feel some discomfort while the catheter is in place, but most individuals who have a long-term catheter adjust to it with time.

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