How to save your dialysis fistula with Angioplasty?

Hello everyone I’m doctor Rozil Gandhi Interventional Radiologist Sushrut Hospital Ahmedabad.

Today we are going to talk about the fistula plasty procedure. Right now I’m going to give information about how to build a fistula and when to build a fistula.

Patients who are going through CKD Chronic Kidney disease and have the disease for a longer period of time. Patients who are having regular dialysis. If there is no urine then dialysis has to be done and it is necessary for life. Dialysis is done two to three times a week. To do dialysis regularly requires a Superficial Av fistula. AV means Arteriovenous fistula. In this procedure, we fix veins and arteries and because of that, there is a fast flow of blood in the veins. 

Dialysis punctures the blood veins and this puncture cleans the blood in the vein. Many times these bad veins in our body block the fistula vein in our body.

What to do if the fistula vein blocks in our body?

Many times we have to make new fistulas in different parts of our body. By doing angioplasty we can reopen the fistula veins in our body. In Heart angioplasty when a Heart attack occurs we open the vein of the heart, the same way we open the fistula vein in our body with the help of angioplasty. With the help of wire, we close the fistula and make it like a balloon. With the help of this balloon plasty the fistula is open and this process is known as Fistula plasty.

The fistula plasty is done without any cut or stitches in the body. This process is done in the local anaesthesia in the body. The patient is discharged within the same day of the treatment. This procedure is the ideal procedure with life-saving for dialysis patients. By this procedure, you can continue only one fistula for a longer period of time so that we don’t have to create any fistula on the other hand and we can save remaining veins in our body.

Thank you so much for listening to this video and if you are having any questions or queries then just ask me and we will be very happy to answer all your questions.

How I Treat Vascular Malformation?

Hello everyone I’m doctor Mohal Banker Interventional radiologist and welcome to this special pain channel.

Today we are going to discuss Vascular Malformation. Vascular malformation is of two types 1) Slow flow Vascular Malformation 2) High flow Vascular Malformation.

So the classification of slow flow and high flow Vascular Malformation is done by the velocity of the blood flow in vascular malformation lesions. 

Now the treatment of vascular malformation is very tricky because the nidus of vascular malformation and the growth of its eager cell lining is very much. If one or two cells are left during the treatment then the pain reappears 1 or 2 years after the treatment. The nidus of the Vascular Malformation should be properly destroyed.

Now we talk about surgery, in surgery muscles are there so it is difficult to remove and some portions of nidus still remain in the body. So Surgery is not a good option. The 2nd option is Steroid Injections like glue, polidocanol. If we use these injections then it will block the blood vessels but it will not destroy the nidus. That’s why the pain reappears in the body. 

The ideal treatment for vascular malformation is Absolute Ethanol Embolization. This embolization destroys the cells of the nidus. Once the cells of the nidus get destroyed then the nidus will also be completely destroyed. This treatment will give the permanent solution for Vascular Malformation. Many times there are multiple nidus in the lesion of the vascular malformation. We have to identify every nidus in the lesions and we have to inject absolute ethanol embolization and destroy the nidus. 

For the treatment of vascular malformation, you need an expert who has treated many cases of Vascular Malformation. The person who knows how to inject absolute ethanol embolization.

Thank you so much for listening to this video and if you are having any questions or queries then just ask me and we will be very happy to answer all your questions.