What is an AV Fistula?

An arteriovenous (AV) fistula is an abnormal connection between an artery and a capillary, usually created operatively for dialysis access, but it can likewise occur because of injury, surgery, or be genetic. The symptoms of an AV fistula depend on its place, size, and whether it’s all-natural or produced. A vascular surgeon Develops an AV Fistula by Linking an Artery Straight to a Vein, regularly in the Lower arm. Connecting The Artery to The Vein Triggers Even More Blood to Circulate into The Capillary. Consequently, The Blood Vessel Enlarges and is Stronger, Making Repetitive Needle Insertions for Haemodialysis Treatments Easier. With the Best AV Fistula Surgeon in Gujarat, India, For The Surgery, You’ll Be Given an anaesthetic. In many cases, The Treatment Can Be Performed on an Outpatient Basis. Before you can begin haemodialysis there needs to be a way to remove the blood from the body and then return it. Your arteries and veins are usually too small, so you will need surgery to create a vascular access site.

What is an AV Graft?

If you have tiny blood vessels that will not establish appropriately into a fistula, you can obtain a Vascular gain access to that connects an artery to a capillary utilizing an artificial tube, or graft, implanted under the skin in your arm. The graft becomes a man-made blood vessel that can be utilized continuously for needle placement and blood accessibility throughout Haemodialysis. A graft doesn’t need to be established as a fistula does, so it can be used sooner after positioning, usually within 2 or 3 weeks.

What is a Venous Catheter?

If your kidney condition has actually progressed quickly, you might not have time to get a permanent Vascular accessibility prior to you starting haemodialysis treatments. You might require the utilization of a venous catheter for short-term access. A Catheter is a tube that is inserted into a capillary in your neck, upper body, or leg near the groin. It has 2 chambers to allow a two-way flow of blood. As soon as a catheter is placed, needle insertion is not essential. Catheters are not ideal for permanent access. They can obstruct, come to be contaminated, and cause tightening of the veins in which they are positioned. However, if you are required to begin haemodialysis immediately, a Catheter will benefit numerous weeks or months while your long-term accessibility develops. For some individuals, the fistula or graft surgical procedure is unsuccessful, and they need to utilize long-term catheter accessibility. Catheters that will be needed for more than about 3 weeks are made to be tunnelled under the skin to boost comfort and lower complications. Even tunnelled catheters, nevertheless, are prone to infection.

During Haemodialysis:

Every haemodialysis session making use of an AV Fistula or AV Graft requires needle insertion. The majority of dialysis centers use 2 needles– one to carry blood to the dialyzer and one to return the washed blood to your body. Some specialized needles are created with 2 openings for two-way flow of blood, but these needles are less efficient.

For some people, using this needle might mean longer therapies. Some people prefer to put their own needles, which requires training to learn how to stop infection and protect the vascular access. You can additionally find out a “ladder” strategy for needle positioning in which you “climb” up the entire size of the fistula, session by session, so you won’t weaken a location with an organizing of needle sticks.

Reasons to Opt for an AV Fistula:

1. Better Long-Term Patency (Durability)

⁍ AV fistulas are made from the patient’s own artery and vein, so they tend to last longer than AV grafts or catheters.
⁍ They are less likely to clot or fail over time.

2. Lower Risk of Infection

⁍ Because there's no foreign material (like in grafts or catheters), fistulas have a significantly lower infection rate.
⁍ Infections from catheters or grafts can be serious and even life-threatening.

3. Fewer Complications

AV fistulas have:
⁍ Lower risk of thrombosis (clotting)
⁍ Lower rates of stenosis (narrowing)
⁍ Reduced risk of steal syndrome compared to grafts

4. Better Dialysis Efficiency

⁍ Fistulas provide high blood flow rates, which help achieve more effective dialysis sessions.
⁍ This results in better clearance of toxins from the body.

5. Cost-Effective

⁍ Though they take longer to mature, AV fistulas require fewer interventions over time, which lowers long-term medical costs.

6. Fewer Hospital Visits

Lower complication rates mean less need for surgical revisions, hospital admissions, or emergency procedures.

Fistula Salvage Treatment

Fistula salvage refers to a range of medical and surgical techniques used to restore the function of a blocked or failing arteriovenous (AV) fistula, which is a critical access point for patients undergoing haemodialysis. The goal is to reopen or maintain the patency of the fistula, thereby avoiding the need for temporary catheters or the surgical creation of a new access site.

1. Vein or Graft Selection

A healthy vein (usually from your leg) or a synthetic graft is used to create a new path for blood flow.

2. Creating the Bypass

The graft is connected above and below the blocked artery—this allows blood to bypass the diseased segment and reach the foot or lower leg.

3. Duration

Surgery takes 2–4 hours.

Treatment Options
for Arterial Disease

Arterial disease can impact your overall health, and we offer personalized treatment options tailored to your unique needs. The term arterial disease refers to the hardening of arteries through plaque buildup, severely impacting blood flow and overall health. Dr Krunal Gohil offers customized care plans for all arterial diseases, such as peripheral artery disease (PAD). He strives to enhance your vascular health and overall quality of life. We ensure early detection, treatment, and ongoing management of your vascular health.
He helps advocate for the optimal vascular well-being of patients to enhance their quality of life. As industry leaders, we utilize cutting-edge technologies and treatment practices that put the patient first, which allows us to support their entire recovery journey—ensuring sustainable vascular health in the long term.

Minimally Invasive Procedures

Percutaneous Transluminal Angioplasty (PTA)

1. Balloon dilatation of stenosed segments.

2. May use high-pressure or cutting balloons.

Thrombectomy / Thrombolysis

For acute thrombosis:
Pharmacomechanical thrombolysis – Uses agents like tpa (tissue plasminogen activator).
Mechanical thrombectomy devices – e.g., AngioJet, Arrow-Trerotola.
Balloon decluttering – Pushes thrombus into the central vein for clearance.

Stent or Stent Graft Placement

1. Used if there’s elastic recoil, vessel rupture, or recurrent stenosis.

2. Covered stents (e.g., Viabahn) may be used for long segments.

Angioplasty

Balloon Angioplasty

What It Does: A balloon catheter is inflated inside the vessel to dilate
Used For:
- short segment blockage

Angioplasty

Optional Stenting

Used For:

- Long segment blockage
- Calcified artery

Stenting

Surgical Treatments

In advanced cases, surgical intervention may be required.

Bypass Surgery: A graft is used to reroute blood around a blocked artery.
Endarterectomy: Surgical removal of plaque from the arteries, particularly in cases of carotid artery disease.

Central Vein Angioplasty

Central vein angioplasty is a minimally invasive endovascular procedure used to treat stenosis or occlusion of the central veins, such as the subclavian vein, brachiocephalic vein, or superior vena cava (SVC). These veins are crucial pathways for blood returning from the upper extremities,
especially in patients with arteriovenous (AV) fistulas or grafts for haemodialysis. Central vein stenosis is often a consequence of previous central venous catheter placement, which can cause intimal injury, fibrosis, and eventual luminal narrowing. This leads to symptoms like arm or facial swelling, venous hypertension, collateral vein formation, and dialysis dysfunction due to poor outflow.

Central vein angioplasty

My philosophy

Why Choose Us for Fistula Treatment?

Experienced Surgeon

Dr. Krunal Gohil uses medical expertise, advanced technology, and compassion to provide unmatched, patient-centred vascular care.

Patient-Centered Approach

We work closely with you to ensure that your individual needs and concerns are addressed at every step of the treatment process.

Comprehensive Care

From initial emergency intervention to long-term rehabilitation, we offer complete care for your recovery.

Advanced Technology

We utilize the most advanced diagnostic tools, including angiography and ultrasound, to assess and treat fistula.

Take charge of your vascular health today.

If you or a loved one has experienced fistula, timely treatment is essential for the best possible outcome. Reach out to our clinic today to schedule a consultation or get more information on our fistula services. We are here to help you regain your health and quality of life.