Fistula Management in Santa Fe: Maintaining Flow for Adequate Hemodialysis

Dialysis patients in Santa Fe need their fistulas to be monitored regularly to make sure that the fistula maintains its flow above the minimum required level. If your fistula isn’t maintaining this level, your doctor might need to perform an intervention to help it maintain the flow rate. This guide on fistula management in Santa Fe will help you understand how your fistula works and what steps you can take if it starts to fail so that you can get back on track with adequate dialysis Management in Santa Fe.

Introduction:
Dialysis Management Santa Fe is the most common access type and is often placed by vascular surgeons. Patients with dialysis fistulas have unique needs. The flow through the fistula must be maintained above a certain level to allow adequate hemodialysis. The fistulas can be monitored with Doppler and color-flow ultrasound to determine if a narrowing (stenosis) is developing or if an abscess is forming.

Diagnosing Fistula Flow Problems:
A fistula is a catheter or graft that connects an artery and vein to bypass a diseased kidney. This connection usually takes the form of an artificial tunnel (fistula) from the artery to the vein, so that blood flows from one directly into the other with no intervening capillary bed.
The fistulas can be monitored with Doppler and color-flow ultrasound to determine if a narrowing (stenosis) is developing or if an obstruction has occurred.

Narrowings Require Therapy:
A narrowing (stenosis) of the fistula can be caused by several factors, including inflammation or scarring. When these issues are present, we will often prescribe an antibiotic or immunosuppressant to help reduce the inflammation and/or promote healing. The fistulas can also be monitored with Doppler and color-flow ultrasound to determine if there is a stenosis present.

Stenoses Require Complete Stent Placement:
In some instances, stenosis may be treated with a stent. Patients with dialysis fistulas have unique needs and stenoses can be fatal if not managed appropriately. The flow through the fistula must be maintained above a certain level to allow adequate hemodialysis. The fistulas can be monitored with Doppler and color-flow ultrasound to determine if a narrowing (stenosis) is developing or if an event such as trauma causes swelling of the vessel.

Color-Flow Imaging Has Limited Utility:
Color-flow imaging has been used to monitor the flow through a dialysis fistula, but it is limited because it can only measure velocity and not flow volume. The Doppler device measures the amount of blood flow, which reflects both velocity and volume. If stenosis develops, color-flow imaging may not detect the narrowing until it is severe enough to cause symptoms or complications.

With Wire Stents, There is Limited Data to Guide Treatment Options:
The most common method of fistula management is wire stents, which are inserted into the fistula tract to maintain the flow. The number and length of stents used to depend on factors such as stenosis (narrowing) and patency (openness). Limited data exist to guide treatment options for dialysis patients with narrowing or patency issues.

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