Your SlideShare is downloading. ×
  • Like
Av access complications
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×

Now you can save presentations on your phone or tablet

Available for both IPhone and Android

Text the download link to your phone

Standard text messaging rates apply

Av access complications

  • 1,472 views
Published

AV FISTULA A PROCEDURE FOR HAEMODIALYSIS HAS MANY COMPLICATIONS AND LEADS TO FAILURE OF FISTULA AND NEED FOR NEW SITE

AV FISTULA A PROCEDURE FOR HAEMODIALYSIS HAS MANY COMPLICATIONS AND LEADS TO FAILURE OF FISTULA AND NEED FOR NEW SITE

Published in Health & Medicine
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
No Downloads

Views

Total Views
1,472
On SlideShare
0
From Embeds
0
Number of Embeds
0

Actions

Shares
Downloads
92
Comments
0
Likes
2

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. DR KIRAN DAVE MS,FRCS VASCULAR AND ENDOVASCULAR SURGEON
  • 2. COMPLICATION  AVF IS CONSIDERED A MINOR PROCEDURE  INCIDENCE OF COMPLICATION- 20 -27%  MANY A COMPLICATION LEADS TO FAILURE OF FISTULA  LOSS OF SITE AND VEIN FOR FURTHER USE  CAN BE AVOIDED BY PLANNING ,TECHNIQUE AND PROPER USE OF FISTULA
  • 3. COMPLICATION  BLEEDING  INFECTION  THROMBOSIS  NON MATURATION OF VEIN  PSEUDOANEURYSM  DISTAL ISCHEMIA  VENOUS OEDEMA  CARDIAC FAILURE -
  • 4. BLEEDING  PRIMARY – SUTURE LINE BLEEDS – HAEMATOMA – OCCLUSION OF FISTULA  REACTIONARY – HYPERTENSION  SECONDARY – INFECTION – NEEDS LIGATION OF FISTULA
  • 5. THROMBOSIS  EARLY – WITH IN 48 HRS – OCCLUSION OF FISTULA ( HYPERCOAGUBLE STATE, HYPOTENSION, HAEMATOMA, POOR VEIN CALIBRE, DISTAL THROMBOSIS)  LATE – SAME AS ABOVE , PUNCTURE SITE INTIMAL HYPERPLASIA , HAEMATOMA , SEPSIS ,HYPOTENSION
  • 6. INFECTION  INCIDENCE IS LOW  USE OF PROPHYLACTIC ANTIBIOTICS  DRESSING  FISTULA CARE
  • 7. NON MATURATION OF FISTULA  INCIDENCE OF UPTO 27 %  POOR VEIN CALIBRE  PREVIOUS PHLEBITIS  CALCIFIED ARTERIES  COMMON IN DIABETICS  IMPROPER SURGERY  REMEDY- NEW SITE / NEW FISTULA
  • 8. PSEUDOANEURYSM  SWELLING AT SITE OF FISTULA  PAIN  CONFIRM ON DOPPLER  RISK OF RUPTURE HIGH  LIGATION OF FISTULA AND ARTERY  MAY REQUIRE A VENOUS GRAFT
  • 9. CARDIAC FAILURE  OVER FUNCTIONING OF FISTULA  PROXIMAL FISTULA  LARGE ANASTOMOSIS  REMEDY – CLOSURE OF FISTULA
  • 10. DISTAL ISCHEMIC SYMPTOMS  ALLENS TEST IS MUST – TO CHECK PATENCY OF PALMAR ARCH  COMMON IN BRACHIAL FISTULAS  INCIDENCE – 4%  EARLY DIAGNOSIS AND CORRECTION OF INFLOW- ARTERIAL THROMBOSIS  STEAL SYNDROME – NARROWING OF FISTULA OR LIGATION
  • 11. VENOUS OEDEMA  COMMON IN SIDE TO SIDE FISTULA  VENOUS OUTFLOW OBSTUCTION  CORRECTION OF VENOUS OBSTRUCTION – VENOGRAPHY-PLASTY – SALVAGE FISTULA  ASSESSMENT OF VENOUS ANATOMY BY DOPPLER  USE THE SITE OPP TO CENTRAL VENOUS ACCESS
  • 12. COMPLICATION -SYNTHETIC GRAFT  THROMBOSIS  INFECTION  PSEUDOANEURYMS  REMOVAL OF GRAFT – INFECTION OR ANEURYSM
  • 13. COMPICATION OF CV CATHETERS  INFECTION – FEVER , RIGORS DURING DIALYSIS  OCCLUSION – VENOUS THROMBOSIS  DURING INSERTION – TRAUMA TO ARTERY AND VEIN  MIGRATION – FRACTURE OF CATHETER
  • 14. CONCLUSION  MANY A COMPLICATION LEADS TO LOSS OF FISTULA  PROPER VASCULAR ASSESSMENT BEFORE AVF FORMATION IS MUST  EARLY DIAGNOSIS AND INTERVENTION CAN SALVAGE AVF
  • 15. THANK YOU