Arteriovenous Fistula Treatment in Gurgaon

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Introduction

An arteriovenous fistula is a condition with an abnormal artery and vein connection. Patients with this condition are at risk of heart failure. Dr. Vikas Kathuria generally diagnoses it with imaging techniques. Various options are available to manage arteriovenous fistula. Early diagnosis and proper Arteriovenous Fistula Treatment are crucial to prevent complications, restore normal blood circulation, and protect overall cardiovascular health.

What Is Arteriovenous Fistula?

Blood flow through a normal channel throughout the body. It flows from the arteries to the smaller capillaries and then to the veins. Capillaries are responsible for delivering nutrients and oxygen to the underlying tissues. However, in arteriovenous fistula, the blood, at some places, flows directly from the arteries into the veins. Thus, it bypasses the capillaries in between. It results in a low supply of blood to the tissues that are dependent on those capillaries.

Although arteriovenous fistula can develop in any part of the body, it commonly occurs in the legs. The doctors also surgically create arteriovenous fistula in patients with chronic kidney diseases. If left untreated, it may result in severe complications.

An arteriovenous fistula may be present during the birth, known as a congenital arteriovenous fistula. It may also develop due to injury, known as an acquired arteriovenous fistula.

What Are The Various Types Of Arteriovenous Fistula?

There are various types of arteriovenous fistula. Some are:

  • Acquired arteriovenous fistulas:The patient may develop arteriovenous fistula through an injury. It may develop due to stabbing or gunshot.
  • Dural arteriovenous fistulas: Durameter is one of the membranes that cover the brain. The condition may or may not present symptoms at birth. The large arteriovenous fistula may result in cardiac complications.
  • Pial or cerebral arteriovenous fistulas: This occurs in the piameter, a brain membrane. A large arteriovenous fistula causes cardiac complications, while a smaller one causes brain damage.
  • Vein of Galen arteriovenous fistulas: Such arteriovenous fistula causes hydrocephalous, cardiac complications, and brain damage.
  • Peripheral arteriovenous fistulas:This type ofarteriovenous fistula may occur in the liver. It results in the direct connection between the hepatic artery and the hepatic vein.

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What Are The Symptoms Of Arteriovenous Fistula?

Symptoms of arteriovenous fistula depend upon its site. Following are some of the common symptoms:

  • Reduced blood pressure
  • Fatigue and weakness
  • Bulging veins which are purple
  • Arm and leg swelling
  • Heart failure or other cardiac complications

If the patient has a pulmonary arteriovenous fistula, he may experience bluish skin, blood in cough, and finger clubbing. An arteriovenous fistula in the digestive system may cause digestive bleeding.

What Are The Causes Of Arteriovenous Fistula?

Following are the causes of arteriovenous fistula:

  • Congenital: This type of arteriovenous fistula is present by birth. The exact reason for this remains unknown.
  • Genetic:Various genetic conditions may result in arteriovenous fistulae, such as Osler-Weber-Rendu disease.
  • Injury:Arteriovenous fistula may also occur due to injuries such as a stabbing or other piercing injury.
  • Surgery:Surgeons createarteriovenous fistula in patients with dialysis.

What Are The Risk Factors For Arteriovenous Fistula?

Various factors increase the risk of developing arteriovenous fistula. These are high blood pressure, exposure to piercing injuries, obesity or overweight, advanced age, female, and certain medications.

What Are The Complications Of Arteriovenous Fistula?

Some of the complications of arteriovenous fistula are:

  • Pain in the peripheral organs: If the arteriovenous fistula develops in your peripheral organs, such as your legs, you may experience pain.
  • Cardiac failure: Cardiac failure is one of the severe complications of arteriovenous fistula. As the blood travels faster through the arteriovenous fistula, the heart needs to perform extra work to keep the blood moving. It, in the long term, may cause heart failure.
  • Clotting: Arteriovenous fistula may also result in clot formation. Clot formation becomes serious if it reaches to lungs or brain.
  • Bleeding: If the arteriovenous fistula develops in the digestive system, it may result in bleeding.

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How The Doctor Diagnoses Arteriovenous Fistula?

There are various techniques to diagnose arteriovenous fistula. These are:

  • Physical evaluation: The doctor uses the stethoscope to hear the flow of blood through the peripheral organs. The sound of blood flow through the arteriovenous fistula is abnormal and makes a humming sound.
  • Imaging techniques: The doctor may recommend various imaging techniques to diagnose arteriovenous fistula. These are ultrasound, Magnetic resonance angiography, and CT angiogram.

What Are The Treatment Options For Arteriovenous Fistula?

Following are some of the treatment options for arteriovenous fistula:

  • Endovascular embolization: This is the most common treatment option for arteriovenous fistula. In this method, the surgeon inserts the catheter into the femoral artery. Through X-ray imaging, the surgeon reaches the site of the arteriovenous fistula. The surgeon then injects the material at the arteriovenous fistula to stop the flow of blood.
  • Ultrasound-guided compression: The surgeons use this method in people with arteriovenous fistula in their legs. In this method, the surgeon compresses the fistula through the ultrasound probe to prevent blood flow.
  • Surgery: Doctors performs various types of surgeries to manage arteriovenous fistula. These are microsurgery and stereotactic radiosurgery.

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    FAQs on Arteriovenous (AV) Fistula Treatment

    1. What is an AV fistula and why is it treated?

    An arteriovenous fistula is an abnormal connection between an artery and a vein. It can occur naturally, due to injury, or as part of dialysis preparation.

    • Treatment is required when the fistula causes symptoms like swelling, pain, bleeding, high blood pressure, or heart strain.

    • In dialysis patients, AV fistulas are surgically created to provide reliable access for blood filtration.

    2. What are the common symptoms of an AV fistula?

    Typical symptoms include:

    • Swelling or bulging vein in the affected area

    • Pain or discomfort near the site

    • Pulsating mass under the skin

    • Warmth or redness around the area

    • Fatigue or decreased exercise tolerance

    • In severe cases, heart failure or high-output cardiac issues

    Tip: Early detection is crucial to prevent complications.

    3. How is an AV fistula diagnosed?

    A doctor may use:

    • Physical examination (checking for thrill or bruit – vibration or sound over the fistula)

    • Ultrasound imaging to visualize the connection

    • Angiography for detailed blood vessel mapping

    • MRI or CT scan in complex cases

    4. What treatment options are available for AV fistulas?

    Treatment depends on the cause, size, and symptoms of the fistula:

    • Observation & Monitoring:

      • If small and not causing symptoms, doctors may simply monitor it.

    • Minimally Invasive Endovascular Procedures:

      • Embolization: Inserting coils, glue, or plugs to block abnormal blood flow.

      • Stent Placement: Reinforces the vessel and restores normal flow.

    • Surgical Intervention:

      • Ligation or Repair: Directly closing the abnormal connection.

      • Bypass Surgery: Creating a new path for blood flow around the fistula.

      • Surgical Creation for Dialysis Access: Purposefully creating a fistula in patients with kidney failure.

    5. How long does it take to recover after AV fistula treatment?

    Recovery depends on the type of procedure:

    • Endovascular (minimally invasive): 1–2 weeks for most patients.

    • Open surgery: 2–4 weeks with proper wound care and follow-up.

    • Patients are advised to avoid heavy lifting and closely monitor the site for signs of infection or bleeding.

    6. Are there risks or complications with AV fistula treatment?

    While generally safe, potential risks include:

    • Infection at the surgical site

    • Bleeding or bruising

    • Blood clot formation

    • Recurrence of the fistula

    • Reduced blood flow to surrounding tissues

    • Rarely, nerve damage or long-term vascular problems

    Your doctor will discuss these risks before treatment and guide you on how to minimize them.

    Conclusion

    An AV fistula can significantly affect blood flow and overall health if left untreated. With today’s advanced minimally invasive techniques and surgical options, most patients achieve excellent outcomes. Early detection, proper treatment planning, and consistent follow-up care are key to preventing complications and ensuring long-term success.

    If you suspect symptoms of an AV fistula or are preparing for dialysis, consult a vascular surgeon or neurosurgeon immediately to discuss the best treatment plan for your condition.

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