01
AV Fistula
A surgically created connection between an artery and a vein that may provide durable access for haemodialysis when suitable.
Dialysis Vascular Access Care
Vascular Access & AV Fistula Treatment in Hyderabad
Specialist evaluation for dialysis access concerns, including AV fistula creation, narrowing, blockage, access salvage and selected endovascular procedures.
Understanding Dialysis Access
What Is Vascular Access?
Vascular access provides a route for blood to leave and return to the body during haemodialysis. The most appropriate option depends on vascular anatomy, dialysis needs and clinical assessment.
02
AV Graft
A graft connects an artery and a vein when a native fistula is not suitable or another access approach is recommended.
03
Dialysis Catheter
A catheter may be used when dialysis access is needed urgently or when an alternative access plan is clinically appropriate.
Warning Signs
When Should Dialysis Access Be Assessed?
Report changes in your access to your dialysis team. Some problems need urgent assessment.
Reduced or Absent Thrill
A change in the usual vibration over an AV fistula may indicate reduced flow or a blockage.
Difficulty During Dialysis
Repeated needle-placement problems, poor blood-flow rates or increased venous pressures may require assessment.
Arm or Hand Swelling
New swelling can be associated with venous outflow problems and should be reviewed.
Unusual Bleeding
Persistent or heavy bleeding from the access site requires prompt medical attention.
Redness or Discharge
Redness, warmth, tenderness or discharge may indicate infection and should be assessed.
Hand Pain or Coldness
New pain, numbness, weakness or coldness in the access-side hand needs clinical evaluation.
When to seek urgent medical help
For uncontrolled bleeding, severe or rapidly increasing pain or swelling, signs of serious infection, or sudden loss of the usual fistula thrill, contact your dialysis team immediately or seek urgent medical care as appropriate.
Treatment Options
Vascular Access Procedures
Care is selected according to the access problem, imaging findings, dialysis requirements and the patient's overall condition.
01
AV Fistula Creation
Surgical creation of a native fistula after assessment of the available arteries and veins.
02
Fistula Salvage or Revision
Selected surgical or endovascular procedures may help preserve or revise a compromised access.
03
Fistuloplasty
Balloon angioplasty may be used to treat a narrowing that restricts blood flow through dialysis access.
04
Fistulogram
Contrast imaging can help identify narrowing, obstruction or other abnormalities affecting access flow.
05
Thrombectomy
Selected thrombosed access may need clot removal and treatment of an underlying narrowing.
06
Central Vein Angioplasty
In selected patients, endovascular treatment may be considered for central venous narrowing that affects access outflow.
How Fistuloplasty May Help
A catheter-mounted balloon is guided to a narrowed area and inflated to widen the vessel. Treatment is considered for selected patients after vascular imaging and specialist assessment.
Assessment & Planning
How Vascular Access Treatment Is Planned
The treatment plan is individualized using the patient's symptoms, dialysis history, vascular anatomy and access function.
Clinical Assessment
Review symptoms, dialysis access, prior procedures and dialysis-related concerns.
Mapping or Imaging
Ultrasound mapping or other imaging may be used to assess the vessels and access.
Identify the Problem
Assess for narrowing, thrombosis, poor maturation, outflow obstruction, infection or other complications.
Choose Treatment
Options may include monitoring, angioplasty, thrombectomy, revision or a new access plan.
Follow-Up
Ongoing observation and communication with the dialysis team can help detect recurrent problems.
Everyday Access Care
Why AV Fistula Care Matters
Patients who rely on haemodialysis should follow their care team's instructions and report changes in access function.
Protect Your Dialysis Access
- Follow the dialysis team's instructions for access care.
- Check the usual thrill as instructed by your clinical team.
- Report changes in flow, swelling, pain or bleeding.
- Avoid unnecessary pressure or trauma to the access arm.
Report Problems Early
Changes in access flow or symptoms may need examination or imaging. Contact your dialysis team promptly so the cause can be assessed and appropriate referral arranged when necessary.
Vascular & Endovascular Specialist
Dr. Narendranadh Meda
MS (General Surgery), DNB (Vascular Surgery), Fellowship in Vascular Surgery (USA)
Consultant Vascular & Endovascular Surgeon and Foot Care Specialist. Vascular access care is planned according to the patient's dialysis requirements, vascular anatomy and the condition of the existing access.
Common Questions
Vascular Access Treatment FAQs
Answers to common questions about dialysis access and AV fistula care.
What is vascular access for dialysis?
Vascular access is the route used to access the bloodstream during haemodialysis. Common types include AV fistulas, AV grafts and dialysis catheters.
What is an AV fistula?
An AV fistula is a surgically created connection between an artery and a vein that may be used for repeated haemodialysis when suitable.
What is fistuloplasty?
Fistuloplasty is balloon angioplasty used to widen a narrowed segment of dialysis access when clinically appropriate.
What is a fistulogram?
A fistulogram is an imaging study using contrast to evaluate blood vessels and identify narrowing or other abnormalities affecting dialysis access.
What happens if an AV fistula becomes blocked?
A blocked or thrombosed fistula needs prompt assessment. Selected patients may be suitable for clot removal and treatment of an underlying narrowing; others may need revision or another access strategy.
What are signs of an AV fistula problem?
Changes in the usual thrill, poor dialysis blood-flow rates, repeated cannulation problems, swelling, bleeding, infection or new hand pain or coldness should be reported promptly.
Can an AV fistula be saved after it stops working?
Some narrowed or thrombosed fistulas can be treated with endovascular or surgical procedures. Suitability depends on the access anatomy and clinical findings.
What is central vein angioplasty?
Central vein angioplasty may be considered in selected patients with significant central vein narrowing affecting dialysis access outflow.
When should I seek urgent help for access problems?
Seek urgent medical care for uncontrolled bleeding, severe or rapidly worsening pain or swelling, signs of serious infection, sudden loss of the usual fistula thrill or other rapidly worsening symptoms.
Dialysis Access Care in Hyderabad
Concerned About Your AV Fistula or Dialysis Access?
Contact Hyderabad Vascular Center to enquire about an assessment. The appropriate investigation or treatment depends on clinical findings and the patient's dialysis needs.
Medical Disclaimer: This page provides general information and does not replace advice from a qualified healthcare professional. The appropriate vascular access procedure depends on clinical findings, dialysis requirements and vascular anatomy.