ADVERTISEMENT

Q. What are the recommended options for AV fistula placement?

Answered by
Dr. Gupta Abhinav
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Apr 26, 2020

Hello doctor,

This query is for my father in law aged. He is 58 years old and is diabetic and currently under medication for BP also. He has a history of two major heart attacks. In the last five years, he did not have any major heart issues.

Recently due to extensive amount of medications taken for a long time, he started showing signs of high amount of creatinine (currently 6.9). We did a few dialyses. Now doctors have advised doing an AV fistula on his left hand. His left hand is partially amputated from a previous septic shock treatment about four years back. His right hand is fine but an AV fistula there might terribly limit his movements and self-care. We wanted a medical opinion about where the fistula can be placed or can it be near to chest area as an alternate option?

ADVERTISEMENT
#

Hi,

Welcome to icliniq.com.

There are three main types of AVF (arteriovenous fistula). The radiocephalic fistula is a forearm fistula created by anastomosing the side of a radial artery to the end of a cephalic vein. It is also referred to as the Brescia-Cimino fistula. The brachiocephalic fistula is an upper arm fistula created by connecting the side of a brachial artery to the end of a cephalic vein or slightly central to the level of the elbow. Finally, the brachial artery–to–transposed basilic vein (BTB) fistula is another upper arm fistula. This fistula is created by anastomosing the side of a brachial artery to the end of a basilic vein that has been transposed laterally and elevated superficially to make it amenable to dialysis cannulation. Other sites could be leg also.

I advise you to discuss it with your doctor. The patient requires dialysis for sure or you can put a central line and replace it every 15 to 20 days. But AV fistula is the best option.


Was this answer helpful?

 | 

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!



Related Questions:
My dad has been advised temporary dialysis. Does he really require it?

This is more pertinent if there is an impending decrease in the urine output ...   Read full

Creatinine Clearance Calculator

Testing the rate of creatinine clearance shows the kidneys' ability to filter the blood. As renal function declines, creatinine clearance also goes down.   Read full

Will elevated creatinine and lipase levels indicate risk of multiorgan failure in diabetics?

His sugar levels are fine now with HbA1c at 674 ...   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read


Monkeypox Virus - Symptoms, Diagnosis, Treatment, Complications, and Prevention
Monkeypox is a zoonotic viral disease. This virus got its name as it was first noticed in laboratory monkeys in the late...  Read more»
Tomato Fever - Causes, Symptoms, Diagnosis, Treatment, and Prevention
Tomato fever is an unidentified and fast-spreading type of viral infection seen in young children. Scroll down to know m...  Read more»
Histrionic Personality Disorder - Causes, Signs, Symptoms, Diagnosis and Treatment
Histrionic personality disorder causes variations in the thinking ability of a person. Read this article to know more.  Read more»

Ask your health query to a doctor online?

Ask a Nephrologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.