WHAT / Vascular Access for Hemodialysis
Introduction Arteriovenous Fistula
When hemodialysis is chosen for renal failure patients then surgery for arteriovenous fistula has to be done.
Hemodialysis is a medical procedure that uses a special machine (a dialysis machine) to filter waste products from the blood and to restore normal constituents to it. This shuffling of multiple substances is accomplished by virtue of the differences in the rates of their diffusion through a semipermeable membrane (a dialysis membrane). Since hemodialysis is a long-term and regular treatment, therefore arteriovenous fistula surgery is to ensure the vascular access is adequate for the purposes.
A surgeon creates an AV fistula by connecting an artery directly to a vein, frequently in the forearm. Connecting the artery to the vein causes more blood to flow into the vein. As a result, the vein grows larger and stronger, making repeated needle insertions for hemodialysis treatments easier.
If veins are too small to develop fistula, then a vascular access that connects an artery to a vein using a synthetic tube, or graft, implanted under the skin will be chosen. The graft becomes an artificial vein that can be used repeatedly for needle placement and blood access during hemodialysis.
The other option is a venous catheter as a temporary access. A catheter is a tube inserted into a vein in the neck, chest, or leg near the groin. It has two chambers to allow a two-way flow of blood. Once a catheter is placed, needle insertion is not necessary. Left arm is chosen for arteriovenous fistula for right-handed patients, usually a local anesthetic is given so that the risk is reduced greatly and the whole procedure completes within one and half hours. Analgesic and antibiotics are given to postoperative in order to reduce the pain and infection.