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
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
8. 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
9. PSEUDOANEURYSM
SWELLING AT SITE OF FISTULA
PAIN
CONFIRM ON DOPPLER
RISK OF RUPTURE HIGH
LIGATION OF FISTULA AND ARTERY
MAY REQUIRE A VENOUS GRAFT
10. CARDIAC FAILURE
OVER FUNCTIONING OF FISTULA
PROXIMAL FISTULA
LARGE ANASTOMOSIS
REMEDY – CLOSURE OF FISTULA
11.
12. 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
13.
14. 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
17. COMPICATION OF CV CATHETERS
INFECTION – FEVER , RIGORS DURING DIALYSIS
OCCLUSION – VENOUS THROMBOSIS
DURING INSERTION – TRAUMA TO ARTERY AND
VEIN
MIGRATION – FRACTURE OF CATHETER
18. CONCLUSION
MANY A COMPLICATION LEADS TO LOSS OF
FISTULA
PROPER VASCULAR ASSESSMENT BEFORE AVF
FORMATION IS MUST
EARLY DIAGNOSIS AND INTERVENTION CAN
SALVAGE AVF