Alveolar arteriovenous fistula in dialysis patients...Select between autologous and artificial blood vessels after examination
Jan 19, 2025
If the kidneys that filter our body's waste and control moisture and blood pressure fail to function properly, the waste cannot be filtered and toxins accumulate, and in severe cases, death can occur.
If more than 90% of kidney function is disrupted, renal replacement therapy such as hemodialysis or kidney transplantation is required. However, as of 2022, only about 10% of patients requiring renal replacement therapy are receiving kidney transplants, and more than 80% of patients are undergoing hemodialysis.
Hemodialysis is a treatment in which urea and excess moisture are removed from the blood of chronic renal patients with kidney dysfunction using a dialysis device and then injected back into the body. Since a large amount of blood must be moved during dialysis, general peripheral blood vessels cannot be used. Therefore, a dialysis blood vessel that can pass through a large amount of blood, 'bronchial fistula', is needed.
The arteriovenous fistula is largely divided into the autologous and artificial vascular arteriovenous fistula. Autologous arteriovenous fistula is a method of expanding blood vessels under arterial pressure by directly connecting the patient's arteries and veins.
Professor Lee Sang-ah of vascular surgery at Soonchunhyang University Bucheon Hospital explained, `Although there is a low risk of infection or vascular occlusion, the maturity period is 6-8 weeks and additional procedures or surgery may be required if the blood vessels do not grow well.'
Artificial vascular arteriovenous fistula is a method of connecting arteries and veins using artificial blood vessels, which has the advantage of being used after about four weeks, but has a higher risk of infection or vascular obstruction.
Before arteriovenous fistula composition, ultrasound is used to determine which blood vessels to make the arteriovenous fistula. After local anesthesia, the skin is incised to anastomize arteries and veins, or artificial blood vessels are connected to arteries and veins to create arteriovenous fistula. If there are no acute complications after checking for bleeding and arteriovenous fistula for about 1 hour after surgery, they can be discharged on the day of surgery.
Professor Lee Sang-ah said "In the case of autologous arteriovenous fistula, exercise is essential for vascular maturation. It is good to hold and open your hands lightly after surgery, or to exercise consistently using a rubber ball. After six to eight weeks, the veins grow through arterial pressure and strong blood flow, making them available for dialysis."
If the arteriovenous fistula composition was done well, the size of the blood vessels would increase and the vibrations would be felt when touched by hand. However, if the arm swells or hurts and the vibration disappears, there is a possibility of vascular occlusion, so you should consult your medical staff immediately.
If redness, pain, and fever appear in the artificial blood vessel area, it may be a sign of infection, so medical staff should be informed. Edema and bruises may persist for about two weeks after surgery, and care should be taken as arteriovenous blood flows to the vein through the arteriovenous fistula, reducing blood flow to the hand, resulting in distal ischemia or anastomotic bleeding.
Professor Lee Sang-ah said "An arm with an arteriovenous fistula is at risk of damage to the arteriovenous fistula, so blood pressure measurement, intravenous injection, and blood collection should be avoided. Also, you should be careful when you cross your arms, arm pillows, or lying on your side for a long time, as pressure can be applied to your arm vessels. In addition, you should not wear watches, bracelets, or clothes with tight sleeves, and do not carry heavy loads or exercise too much, he said.
If more than 90% of kidney function is disrupted, renal replacement therapy such as hemodialysis or kidney transplantation is required. However, as of 2022, only about 10% of patients requiring renal replacement therapy are receiving kidney transplants, and more than 80% of patients are undergoing hemodialysis.
Hemodialysis is a treatment in which urea and excess moisture are removed from the blood of chronic renal patients with kidney dysfunction using a dialysis device and then injected back into the body. Since a large amount of blood must be moved during dialysis, general peripheral blood vessels cannot be used. Therefore, a dialysis blood vessel that can pass through a large amount of blood, 'bronchial fistula', is needed.
The arteriovenous fistula is largely divided into the autologous and artificial vascular arteriovenous fistula. Autologous arteriovenous fistula is a method of expanding blood vessels under arterial pressure by directly connecting the patient's arteries and veins.
Professor Lee Sang-ah of vascular surgery at Soonchunhyang University Bucheon Hospital explained, `Although there is a low risk of infection or vascular occlusion, the maturity period is 6-8 weeks and additional procedures or surgery may be required if the blood vessels do not grow well.'
Artificial vascular arteriovenous fistula is a method of connecting arteries and veins using artificial blood vessels, which has the advantage of being used after about four weeks, but has a higher risk of infection or vascular obstruction.
Before arteriovenous fistula composition, ultrasound is used to determine which blood vessels to make the arteriovenous fistula. After local anesthesia, the skin is incised to anastomize arteries and veins, or artificial blood vessels are connected to arteries and veins to create arteriovenous fistula. If there are no acute complications after checking for bleeding and arteriovenous fistula for about 1 hour after surgery, they can be discharged on the day of surgery.
Professor Lee Sang-ah said "In the case of autologous arteriovenous fistula, exercise is essential for vascular maturation. It is good to hold and open your hands lightly after surgery, or to exercise consistently using a rubber ball. After six to eight weeks, the veins grow through arterial pressure and strong blood flow, making them available for dialysis."
If the arteriovenous fistula composition was done well, the size of the blood vessels would increase and the vibrations would be felt when touched by hand. However, if the arm swells or hurts and the vibration disappears, there is a possibility of vascular occlusion, so you should consult your medical staff immediately.
If redness, pain, and fever appear in the artificial blood vessel area, it may be a sign of infection, so medical staff should be informed. Edema and bruises may persist for about two weeks after surgery, and care should be taken as arteriovenous blood flows to the vein through the arteriovenous fistula, reducing blood flow to the hand, resulting in distal ischemia or anastomotic bleeding.
Professor Lee Sang-ah said "An arm with an arteriovenous fistula is at risk of damage to the arteriovenous fistula, so blood pressure measurement, intravenous injection, and blood collection should be avoided. Also, you should be careful when you cross your arms, arm pillows, or lying on your side for a long time, as pressure can be applied to your arm vessels. In addition, you should not wear watches, bracelets, or clothes with tight sleeves, and do not carry heavy loads or exercise too much, he said.
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This article was translated by Naver AI translator.
